Improving Prescribing Practices in Primary Care
Author Information
Author(s): Fretheim Atle, Oxman Andrew D, Håvelsrud Kari, Treweek Shaun, Kristoffersen Doris T, Bjørndal Arild
Primary Institution: Norwegian Knowledge Centre for Health Services
Hypothesis
The tailored intervention would be more effective than passive dissemination of the guidelines.
Conclusion
The tailored intervention had a significant impact on prescribing of antihypertensive drugs, but was ineffective in improving the quality of other aspects of managing hypertension and hypercholesterolemia in primary care.
Supporting Evidence
- Thiazides were prescribed to 17% of patients in the intervention group versus 11% in the control group.
- The intervention led to an increase in adherence to guideline recommendations on choice of antihypertensive drug.
- Little or no differences were found for risk assessment prior to prescribing and for achievement of treatment goals.
Takeaway
Doctors were given special help to follow guidelines for prescribing blood pressure and cholesterol medications, and it worked for some drugs but not for others.
Methodology
A cluster-randomized trial comparing a tailored intervention to passive dissemination of guidelines in 146 general practices.
Potential Biases
Some outcomes relied on self-reporting by physicians and patients, which could introduce bias.
Limitations
The study was conducted in only two areas of Norway, and the practices included may not be representative of all general practices in Norway.
Participant Demographics
The study involved 146 general practices with 501 physicians in Norway.
Statistical Information
P-Value
0.001
Confidence Interval
95% CI 1.49–2.49
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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