NDLI: The effect of registry-based performance feedback via short text messages and traditional postal letters on prescribing parenteral steroids by general practitioners--A randomized controlled trial.

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The effect of registry-based performance feedback via short text messages and traditional postal letters on prescribing parenteral steroids by general practitioners--A randomized controlled trial.

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The effect of registry-based performance feedback via short text messages and traditional postal letters on prescribing parenteral steroids by general practitioners--A randomized controlled trial.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Nejad, Afshin Sarafi Noori, Mohammad Reza Farrokhi Haghdoost, Ali Akbar Bahaadinbeigy, Kambiz Abu-Hanna, Ameen Eslami, Saeid
Description	Country affiliation: Iran Author Affiliation: Nejad AS ( Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran); Noori MR ( Medical Documents Audit Office of Kerman-Iranian Social Security Organization-SSOIR, Kerman, Iran.); Haghdoost AA ( Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.); Bahaadinbeigy K ( Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.); Abu-Hanna A ( Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands.); Eslami S ( Pharmaceutical Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran)
Abstract	BACKGROUND: It is conjectured that providing feedback on physicians' prescribing behavior improves quality of drug prescriptions. However, the effectiveness of feedback provision and mode of feedback delivery is not well understood. The objective of this study was to assess and compare the effect of traditional paper letters (TPL) and short text message (STM) feedback on general practitioners' prescribing behavior of parenteral steroids (PSs). METHODS: In a single-blind randomized controlled trial, 906 general practitioners (GPs) having at least 10 monthly prescriptions were randomly recruited into two interventions and one control study arms with 1:1 allocation, stratified by percentage of prescriptions. The intervention was the provision of 3 feedback messages containing prescribing indices in TPL and STM (in the first two arms) versus the control arm (CG) with an interval of 3 months between these messages. We calculated the PS Defined Daily Dose (DDD) for every GP, every month, and compared between the 3 arms, before and after the interventions. The expected primary outcome was to reduce prescription of parenteral steroids by participants. The study was performed in the Kerman Social Security Organization in Iran. RESULTS: A total of 906 GPs were selected for the trial, but only 721 of them (TPL=191, STM=228, CG=302) were recruited for the 1st feedback. The mean age of GPs was 44 and 59% of them were male. The prescribed parenteral steroid DDDs at baseline were similar (TPL=121.62, STM=127.49, CG=115.68, P>0.5). At the end of the study, DDDs in the TPL and STM arms were similar (TPL=104.38, STM=101.90, P>0.9) but DDDs in each intervention arm was statistically significantly lower than in CG (CG=156.17, P<0.0001). Being in TPL and STM arms resulted in 36.1 and 41.7 units of decrease in DDD respectively, compared to the control arm (P<0.02 and P<0.005) after the one-year duration of the study. CONCLUSION: Feedback by TPLs and STMs on prescribing performance effectively reduced prescribing PSs by GPs. STM, being a cheap and fast tool, is potentially powerful and efficient for drug prescription rationalization.
File Format	HTM / HTML
ISSN	13865056
Volume Number	87
e-ISSN	18728243
Journal	International Journal of Medical Informatics
Language	English
Publisher	Elsevier
Publisher Date	2016-03-01
Publisher Place	Ireland
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Medical Informatics Drug Prescriptions Statistics & Numerical Data Feedback General Practitioners Physician's Practice Patterns Steroids Administration & Dosage Task Performance And Analysis Text Messaging Utilization Adult Female Humans Infusions, Parenteral Male Registries Single-blind Method Journal Article Randomized Controlled Trial Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Health Informatics

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