Studies
Effect of Periodic Letters on Evidence-Based Drug Therapy on Prescribing Behaviour: A Randomized Trial
Author: Dormuth C, Maclure M, Bassett K, Jauca C, Whiteside C, Wright J
Intervention Type: Distribution of Educational Materials to Professionals
Disease State: Not specific to any chronic disease
Research Objective
To measure the impact on prescribing behaviour of a series of evidence-based drug therapy letters mailed to physicians in British Columbia on prescribing to newly treated patients
Methods
Design: Cluster randomized controlled trial (by physician) that was 38 months in duration
Study sample: General practitioners; newly-treated community-dwelling adults (66+ years, except for asthma letter where sample was 60+ years)
Intervention:
Group 1 – Intervention: Series of twelve issues of an evidence-based series called, Therapeutics Letter, mailed by the UBC Therapeutics Initiative group addressing a variety of different drug reviews or disease management topics in primary care. Half of the letters were predicted to show an increase in prescriptions to newly treated patients, and half were predicted to show a decrease. Effects of each letter on prescribing were measured by counting the number of newly treated patients who received that letter’s analysis drug before versus after the intervention.
Group 2 – Control: Usual care
Medication Prescribing and Use Outcomes
- Changes in prescribing of letter-specific analysis drugs in the three months following distribution of each letter
Key Results
- The adjusted relative risk for the combined effect of all letters was 1.30 (95% CI: 1.13, 1.52; p<0.05)
- In the intervention group, trends in prescribing changes were in the direction predicted for most of the individual analysis drugs of each letter, but none were statistically significant; there were more changes related to an increase in medications than a decrease.
Key Implementation Issues
- It may be easier to convince general practitioners to start prescribing then to stop prescribing, as a greater change resulted from letters encouraging an increase in prescriptions than for letters encouraging a decrease in prescriptions.
Citation(s)
Effect of Periodic Letters on Evidence-Based Drug Therapy on Prescribing Behaviour: A Randomized Trial. Dormuth, C.R.., Maclure, M., Bassett, K., Jauca, C., Whiteside, C., & Wright, J.M.. Canadian Medical Association Journal (2004), 171(9), 1057-1061