Studies
Effect of Feedback Letters to Physicians and Pharmacists on the Appropriate Use of Medication in the Treatment of Asthma
Author: Blais R, Laurier C, Pare M
Intervention Type: Distribution of Educational Materials to Professionals, Audit and Feedback
Disease State: Respiratory Disease
Research Objective
To assess the impact of feedback letters to physicians and pharmacists on their patients’ appropriate use of asthma medication
Methods
Design: Two randomized controlled trials that were 12 months in duration
Study sample: General practitioners and pharmacists
Intervention:
Group 1 – Physician Intervention: Physicians received 1) three feedback letters on their overall prescribing of asthma medications and compliance with five appropriate use criteria, 2) patient-specific profiles given when consent was granted, 3) pamphlet summarizing asthma treatment guidelines
Group 2 – Physician Control: Usual care by physicians
Group 3 – Pharmacist Intervention: Pharmacists received 1) three feedback letters on their compliance with appropriate use criteria, 2) patient-specific profiles as well as an aggregate profile of all medications dispensed, 3) pamphlet summarizing asthma treatment guidelines
Group 4 – Pharmacist Control: Usual care by pharmacists
Medication Prescribing and Use Outcome(s)
Proportion of prescriptions in compliance with appropriate use criteria per practitioner
Key Results
- The proportion of prescriptions compliant with the appropriate use criteria was not significantly different between intervention and control groups for physicians (p>0.05).
- The proportion of prescriptions dispensed in compliance with the appropriate use criteria was not significantly between pharmacist groups (0.10>p>0.05).
Key Implementation Issues
- Few physicians were able to obtain patient consent to receive patient specific prescribing feedback.
- Time between feedback letters may have been insufficient.
- Overuse of asthma medications may be due to patient behaviour rather than provider behaviour.
- Although change in prescriptions compliance with appropriate use criteria following feedback to pharmacists did not quite reach the 0.05 statistical significance level, feedback to pharmacists is promising, especially when including patients’ names so that pharmacists can intervene more specifically.
Citation(s)
Effect of Feedback Letters to Physicians and Pharmacists on the Appropriate Use of Medication in the Treatment of Asthma. Blais, R., Laurier, C., & Pare, M. (2008). Journal of Asthma, 45(3), 227-231.