2017
DOI: 10.1007/s11096-017-0553-0
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A multifaceted intervention to reduce guideline non-adherence among prescribing physicians in Dutch hospitals

Abstract: Background Despite the potential of clinical practice guidelines to improve patient outcomes, adherence to guidelines by prescribers is inconsistent. Objective The aim of the study was to determine whether an approach of introducing an educational programme for prescribers in the hospital combined with audit and feedback by the hospital pharmacist reduces non-adherence of prescribing physicians to key pharmacotherapeutic guidelines. Setting This prospective intervention study with a before–after design evaluat… Show more

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Cited by 14 publications
(16 citation statements)
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References 26 publications
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“…optimal practice is not achieved in many hospitals. 4,[8][9][10] In this study, the practice of thoracic surgeons in Iran is fairly consistent with ASHP guidelines in terms of prescribing SAP. This finding is in accordance with a previous report in which a questionnaire was used to evaluate the knowledge, attitude and practice of thoracic surgeons.…”
Section: Discussionsupporting
confidence: 73%
See 1 more Smart Citation
“…optimal practice is not achieved in many hospitals. 4,[8][9][10] In this study, the practice of thoracic surgeons in Iran is fairly consistent with ASHP guidelines in terms of prescribing SAP. This finding is in accordance with a previous report in which a questionnaire was used to evaluate the knowledge, attitude and practice of thoracic surgeons.…”
Section: Discussionsupporting
confidence: 73%
“…Evidence for the effectiveness of SAP prescription is well established. Nevertheless, some studies suggest that optimal practice is not achieved in many hospitals . In this study, the practice of thoracic surgeons in Iran is fairly consistent with ASHP guidelines in terms of prescribing SAP.…”
Section: Discussionsupporting
confidence: 67%
“…Bos et al introduced an educational program for prescribers in the hospital combined with audit and feedback by the hospital pharmacist. This led to a significant decrease in non-adherence from 30.5 to 21.8% of prescribing physicians to key pharmacotherapeutic guidelines, such as gastric protection in case of use of NSAID in hospitalized surgical patients and perioperative bridging of antithrombotics [ 14 ]. Other multifaceted intervention studies focusing on antibiotics found an increase in the rate of guideline adherence of antibiotic prescription [ 27 , 28 ].…”
Section: Discussionmentioning
confidence: 99%
“…Education programs together with computer-based clinical decision support systems showed significant improvements in adherence to guidelines for venous thromboembolism in hospitals [ 13 ]. Bos et al [ 14 ] showed that education of hospital prescribers combined with audit and feedback by hospital pharmacists reduced physician non-adherence to guidelines covering pain management, antithrombotics, fluid and electrolyte management, application of radiographic contrast agents and surgical antibiotic prophylaxis. Furthermore, Maynard and colleagues evaluated the impact of the implementation of a multidisciplinary team on inpatient anticoagulation and management of venous thromboembolism in 189 patients with 211 identified VTE events [ 15 ].…”
Section: Introductionmentioning
confidence: 99%
“…If pharmacists educate inpatients about not only the benefits but also the potential side effects of their medications, as well as on drug use and therapeutic goals, then their improved knowledge, attitude and practice helps to reduce ADEs following discharge . In addition, a study in Dutch hospitals by Bos et al showed how the combination of an educational programme and medication counselling for prescribing physicians on surgical, urological and orthopaedic wards led to a significant reduction (from 30.5% [332/1089] to 21.8% [193/886], P < .05) in non‐adherence to guidelines, and this effect was strengthened by a weekly visit from the hospital pharmacist . For patients, personalized educational material is called for, containing information on possible adverse reactions and the measures to take to avoid them, why the medication may be inappropriate, potential alternative treatment options, etc A 2018 randomized clinical trial found that 75% of sedative‐hypnotic drug users successfully completed a tapering protocol compared with 54% in a 2014 trial examining the effect of patient education alone on reducing inappropriate prescriptions .…”
Section: Resultsmentioning
confidence: 99%