A Randomized Controlled Trial of a Drug Use Review Intervention for Sedative Hypnotic Medications

Abstract

The intervention achieved a statistically significant decrease in targeted drug use, and the amount of reduction is likely to have decreased the risk of fractures associated with benzodiazepine use. This study adds to the recent evidence that mailed drug use review interventions can have a desirable impact on patient drug use.

Improving the Success of Mailed Letter Intervention Programs to Influence Prescribing Behaviors: A Review

“…Act (HIPAA) [2][3][4][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] ; provision of such information is uncommon among programs conducted overseas. Programs outside of the United States commonly use prescriber feedback alone or in combination with educational materials to encourage changes in prescribing practices.…”

“…5,6,28,30,32,[43][44][45] In addition to targeting prescribers, several programs (n = 6) also sent correspondence to pharmacies involved in the care of identified patients. 8,[13][14][15]22,23,46 Jing et al (2011) was the only identified program that included both prescribers and patients as intervention recipients. 3 Six of the 7 aforementioned programs concluded that inclusion of a second recipient to be more effective at achieving the targeted outcome as compared with prescriber recipients alone.…”

“…Twenty-one of the 25 programs that provided some form of patient-identifying data were considered to have a significant impact on prescribing. [2][3][4][7][8][9][10][11][12][13][14][15][16][18][19][20][21][22][23]25,48 It should be noted that Meyer et al considered their patient-identifying intervention to be unsuccessful because changes in prescribing patterns were no longer significant at 6 and 12 months postintervention.…”

“…49 Most programs that used patient-identifying data opted to make generalized recommendations that could be applicable to their entire target population. [2][3][4][7][8][9][10][11][12][13][14]16,[18][19][20][21][22][23][24][25]48,49 For example, the intervention conducted by alerted physicians of the identified patient's potential for acetaminophen overuse, discussed the associated risks, and suggested adjusting therapy to meet recommended daily standards. 12 Such a method appears to be an effective intervention tactic, as 20 of 22 programs (90.1%) that provided this type of recommendation were successful.…”

“…6,43 SØndergaard et al (2002) found neither feedback presented as patient count data or in the form of a comparative aggregate graph had an impact on prescribing patterns. 6 Even when combined with educational material or academic detailing, the impact is questionable: Of the 9 programs 5,23,[26][27][28][29][30]32,45 that used prescriber feedback in combination with other techniques, 4 reported minimal to no improvements in prescribing patterns. 5,28,29,32 Additionally, each of the 4 programs that provided educational materials alone were found to have little to no impact on measured outcomes.…”