A RCT evaluating the effectiveness and cost-effectiveness of academic detailing versus postal prescribing feedback in changing GP antibiotic prescribing.

Hdl Handle:
http://hdl.handle.net/10147/302725
Title:
A RCT evaluating the effectiveness and cost-effectiveness of academic detailing versus postal prescribing feedback in changing GP antibiotic prescribing.
Authors:
Naughton, Corina; Feely, John; Bennett, Kathleen
Affiliation:
UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland. corina.naughton@ucd.ie
Citation:
A RCT evaluating the effectiveness and cost-effectiveness of academic detailing versus postal prescribing feedback in changing GP antibiotic prescribing. 2009, 15 (5):807-12 J Eval Clin Pract
Publisher:
Journal of evaluation in clinical practice
Journal:
Journal of evaluation in clinical practice
Issue Date:
Oct-2009
URI:
http://hdl.handle.net/10147/302725
DOI:
10.1111/j.1365-2753.2008.01099.x
PubMed ID:
19811593
Abstract:
The aim of this study is to evaluate the effectiveness of academic detailing (AD) plus postal prescribing feedback versus postal prescribing feedback alone in reducing: (i) the overall rate of antibiotic; and (ii) proportion of second-line antibiotic prescribing. In addition, the cost-effectiveness of an outreach prescriber adviser service versus a postal prescribing feedback service was evaluated.; Volunteer general practitioner practices (n = 98) were randomized to receive prescribing feedback via postal bulletin (PB) (n = 50) or academic detailing plus postal bulletin (AD) (n = 48). Data analysis was based on the HSE-primary care reimbursement service (HSE-PCRS) prescribing database. Regression (beta) coefficients, indicating proportion change in prescribing per month, and 95% confidence intervals (CIs) are presented. The cost-effectiveness ratio was calculated from the total cost of the intervention divided by percentage change in antibiotic prescribing in AD versus PB group.; Immediately post intervention PB (beta = -0.02, 95% CI -0.04, -0.001) and AD (beta = -0.02, 95% CI -0.03, -0.001) practices significantly decreased overall antibiotic prescribing. Second-line antibiotic prescribing was also significantly decreased by 2-3% in both groups. However, there were no significant differences in antibiotic prescribing between the randomized groups in the immediate or long-term post-intervention period. In the cost-effectiveness analysis a postal prescribing feedback service would cost euro 88 per percentage change in prescribing practice compared with euro 778 for a prescriber adviser service.; Prescribing feedback significantly reduced overall and second-line antibiotic prescribing, but academic detailing was not significantly more effective than postal bulletin in changing antibiotic prescribing practice.
Item Type:
Article
Language:
en
Description:
Abstract PURPOSE: The aim of this study is to evaluate the effectiveness of academic detailing (AD) plus postal prescribing feedback versus postal prescribing feedback alone in reducing: (i) the overall rate of antibiotic; and (ii) proportion of second-line antibiotic prescribing. In addition, the cost-effectiveness of an outreach prescriber adviser service versus a postal prescribing feedback service was evaluated. METHODS: Volunteer general practitioner practices (n = 98) were randomized to receive prescribing feedback via postal bulletin (PB) (n = 50) or academic detailing plus postal bulletin (AD) (n = 48). Data analysis was based on the HSE-primary care reimbursement service (HSE-PCRS) prescribing database. Regression (beta) coefficients, indicating proportion change in prescribing per month, and 95% confidence intervals (CIs) are presented. The cost-effectiveness ratio was calculated from the total cost of the intervention divided by percentage change in antibiotic prescribing in AD versus PB group. RESULTS: Immediately post intervention PB (beta = -0.02, 95% CI -0.04, -0.001) and AD (beta = -0.02, 95% CI -0.03, -0.001) practices significantly decreased overall antibiotic prescribing. Second-line antibiotic prescribing was also significantly decreased by 2-3% in both groups. However, there were no significant differences in antibiotic prescribing between the randomized groups in the immediate or long-term post-intervention period. In the cost-effectiveness analysis a postal prescribing feedback service would cost euro 88 per percentage change in prescribing practice compared with euro 778 for a prescriber adviser service. CONCLUSION: Prescribing feedback significantly reduced overall and second-line antibiotic prescribing, but academic detailing was not significantly more effective than postal bulletin in changing antibiotic prescribing practice.
Keywords:
GENERAL PRACTICE; PRESCRIBING
MeSH:
Anti-Bacterial Agents; Cost-Benefit Analysis; Databases as Topic; Drug Prescriptions; Drug Resistance, Microbial; Feedback; Humans; Ireland; Methicillin-Resistant Staphylococcus aureus; Physician's Practice Patterns; Physicians, Family; Postal Service; Program Evaluation
ISSN:
1365-2753

Full metadata record

DC FieldValue Language
dc.contributor.authorNaughton, Corinaen_GB
dc.contributor.authorFeely, Johnen_GB
dc.contributor.authorBennett, Kathleenen_GB
dc.date.accessioned2013-10-04T14:19:14Z-
dc.date.available2013-10-04T14:19:14Z-
dc.date.issued2009-10-
dc.identifier.citationA RCT evaluating the effectiveness and cost-effectiveness of academic detailing versus postal prescribing feedback in changing GP antibiotic prescribing. 2009, 15 (5):807-12 J Eval Clin Practen_GB
dc.identifier.issn1365-2753-
dc.identifier.pmid19811593-
dc.identifier.doi10.1111/j.1365-2753.2008.01099.x-
dc.identifier.urihttp://hdl.handle.net/10147/302725-
dc.descriptionAbstract PURPOSE: The aim of this study is to evaluate the effectiveness of academic detailing (AD) plus postal prescribing feedback versus postal prescribing feedback alone in reducing: (i) the overall rate of antibiotic; and (ii) proportion of second-line antibiotic prescribing. In addition, the cost-effectiveness of an outreach prescriber adviser service versus a postal prescribing feedback service was evaluated. METHODS: Volunteer general practitioner practices (n = 98) were randomized to receive prescribing feedback via postal bulletin (PB) (n = 50) or academic detailing plus postal bulletin (AD) (n = 48). Data analysis was based on the HSE-primary care reimbursement service (HSE-PCRS) prescribing database. Regression (beta) coefficients, indicating proportion change in prescribing per month, and 95% confidence intervals (CIs) are presented. The cost-effectiveness ratio was calculated from the total cost of the intervention divided by percentage change in antibiotic prescribing in AD versus PB group. RESULTS: Immediately post intervention PB (beta = -0.02, 95% CI -0.04, -0.001) and AD (beta = -0.02, 95% CI -0.03, -0.001) practices significantly decreased overall antibiotic prescribing. Second-line antibiotic prescribing was also significantly decreased by 2-3% in both groups. However, there were no significant differences in antibiotic prescribing between the randomized groups in the immediate or long-term post-intervention period. In the cost-effectiveness analysis a postal prescribing feedback service would cost euro 88 per percentage change in prescribing practice compared with euro 778 for a prescriber adviser service. CONCLUSION: Prescribing feedback significantly reduced overall and second-line antibiotic prescribing, but academic detailing was not significantly more effective than postal bulletin in changing antibiotic prescribing practice.en_GB
dc.description.abstractThe aim of this study is to evaluate the effectiveness of academic detailing (AD) plus postal prescribing feedback versus postal prescribing feedback alone in reducing: (i) the overall rate of antibiotic; and (ii) proportion of second-line antibiotic prescribing. In addition, the cost-effectiveness of an outreach prescriber adviser service versus a postal prescribing feedback service was evaluated.-
dc.description.abstractVolunteer general practitioner practices (n = 98) were randomized to receive prescribing feedback via postal bulletin (PB) (n = 50) or academic detailing plus postal bulletin (AD) (n = 48). Data analysis was based on the HSE-primary care reimbursement service (HSE-PCRS) prescribing database. Regression (beta) coefficients, indicating proportion change in prescribing per month, and 95% confidence intervals (CIs) are presented. The cost-effectiveness ratio was calculated from the total cost of the intervention divided by percentage change in antibiotic prescribing in AD versus PB group.-
dc.description.abstractImmediately post intervention PB (beta = -0.02, 95% CI -0.04, -0.001) and AD (beta = -0.02, 95% CI -0.03, -0.001) practices significantly decreased overall antibiotic prescribing. Second-line antibiotic prescribing was also significantly decreased by 2-3% in both groups. However, there were no significant differences in antibiotic prescribing between the randomized groups in the immediate or long-term post-intervention period. In the cost-effectiveness analysis a postal prescribing feedback service would cost euro 88 per percentage change in prescribing practice compared with euro 778 for a prescriber adviser service.-
dc.description.abstractPrescribing feedback significantly reduced overall and second-line antibiotic prescribing, but academic detailing was not significantly more effective than postal bulletin in changing antibiotic prescribing practice.-
dc.language.isoenen
dc.publisherJournal of evaluation in clinical practiceen_GB
dc.rightsArchived with thanks to Journal of evaluation in clinical practiceen_GB
dc.subjectGENERAL PRACTICEen_GB
dc.subjectPRESCRIBINGen_GB
dc.subject.meshAnti-Bacterial Agents-
dc.subject.meshCost-Benefit Analysis-
dc.subject.meshDatabases as Topic-
dc.subject.meshDrug Prescriptions-
dc.subject.meshDrug Resistance, Microbial-
dc.subject.meshFeedback-
dc.subject.meshHumans-
dc.subject.meshIreland-
dc.subject.meshMethicillin-Resistant Staphylococcus aureus-
dc.subject.meshPhysician's Practice Patterns-
dc.subject.meshPhysicians, Family-
dc.subject.meshPostal Service-
dc.subject.meshProgram Evaluation-
dc.titleA RCT evaluating the effectiveness and cost-effectiveness of academic detailing versus postal prescribing feedback in changing GP antibiotic prescribing.en_GB
dc.typeArticleen
dc.contributor.departmentUCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland. corina.naughton@ucd.ieen_GB
dc.identifier.journalJournal of evaluation in clinical practiceen_GB

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