Improving Prescribing Practices in Primary Care
Author Information
Author(s): Atle Fretheim, Morten Aaserud, Andreas D. Oxman
Primary Institution: Norwegian Knowledge Centre for Health Services
Hypothesis
Can a tailored intervention improve the prescribing of antihypertensive and cholesterol-lowering drugs in primary care?
Conclusion
The intervention significantly increased the prescribing of thiazides, but the costs of the intervention exceeded the savings during the study period.
Supporting Evidence
- The intervention led to a 9.3% increase in thiazide prescriptions.
- The cost per additional patient started on thiazides was US$454.
- The net annual cost of the intervention was US$53,395.
- Predicted savings from a national program could reach US$761,998 after two years.
Takeaway
Doctors were encouraged to use cheaper thiazide medications for high blood pressure, which they did, but it cost more to promote this change than the money saved.
Methodology
A cluster randomized trial involving 146 general practices in Norway, comparing a tailored intervention to usual care.
Potential Biases
Potential biases related to the self-reported nature of prescribing practices and the influence of external factors on prescribing behavior.
Limitations
The intervention's cost-effectiveness was only evaluated over a one-year period, and the long-term sustainability of the prescribing changes is uncertain.
Participant Demographics
General practices in Norway, with 257 physicians in the intervention group and 244 in the control group.
Statistical Information
P-Value
0.001
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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