Nudging to prudence? The effect of reminders on antibiotics prescriptions

Östervall, Linnea Wickström

doi:10.1016/j.jebo.2017.01.001

Cited by 7 publications

(1 citation statement)

References 4 publications

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“…These theories have been synthesised into the Theoretical Domains Framework (Atkins et al 2017). This has influenced the design of specific information and educational interventions, including designing audit and feedback interventions for physicians (Eccles et al 2001, ?, Kolstad 2013, Ivers et al 2014, Östervall 2017. Audit and feedback are now regarded as effective interventions based on managing overconfidence, cognitive dissonance and loss aversion (Ivers et al 2014).…”

Section: Behavioral Interventions To Change Physician Behaviormentioning

confidence: 99%

Physician Behavior and Health Outcomes

Godager

Scott

2023

Handbook of Labor, Human Resources and Population Economics

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There is increasing empirical evidence of patient harm and resource waste from over-diagnosis, over-treatment, medical errors, and the underuse of effective care. This chapter reviews recent literature on physician behavior and health outcomes. Research on the economics of physician behavior takes a classical economic perspective based on using financial incentives to solve information problems in healthcare markets. The evidence on payment methods, competition and market organization, and information interventions is summarized. Incentives matter, but may matter less in the presence of altruistic motives amongst most physicians, as well as the presence of complex multi-tasking decision environments. More contemporary research on physician behavior has taken a behavioral perspective where it is acknowledged that physician decision making can be biased even in cases where incentive and information problems are absent. The large health services research literature on professional behavior change incorporates behavioral and psychological perspectives yet integration into economic models of physician behavior is still in its early stages.Though research on incentives continues to dominate the health economics literature, evidence suggests that behavioral approaches are important not only in understanding incentives, but in changing physicians' behavior using non-pecuniary interventions.

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Section: Behavioral Interventions To Change Physician Behaviormentioning

confidence: 99%

Physician Behavior and Health Outcomes

Godager

Scott

2023

Handbook of Labor, Human Resources and Population Economics

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Nudging clinicians: A systematic scoping review of the literature

Lamprell

Tran

Arnolda

et al. 2020

Evaluation Clinical Practice

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Background While the quality of medical care delivered by physicians can be very good, it can also be inconsistent and feature behaviours that are entrenched despite updated information and evidence. The “nudge” paradigm for behaviour change is being used to bring clinical practice in line with desired standards. The premise is that behaviour can be voluntarily shifted by making particular choices instinctively appealing. We reviewed studies that are explicit about their use of nudge theory in influencing clinician behaviour. Methods Databases were searched from April 2008 (the publication date of the book that introduced nudge theory to a wider audience) to November 2018, inclusive. The search strategy and narrative review of results addressed the Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews. Results 22 studies were identified. Randomized trials or pre‐post comparisons were generally used in community‐based settings; single‐site pre‐post studies were favoured in hospitals. The studies employed eight intervention types: active choice; patient chart redesign; default and default alerts; partitioning of prescription menus; audit and feedback; commitment messages; peer comparisons; and redirection of workflow. Three core cognitive factors underpinned the eight interventions: bias towards prominent choices (salience); predisposition to social norms; and bias towards time or cost savings. Conclusions Published studies that are explicit about their use of nudge theory are few in number and diverse in their settings, targets, and results. Default and chart re‐design interventions reported the most substantial improvements in adherence to evidence and guideline‐based practice. Studies that are explicit in their use of nudge theory address the widespread failure of clinical practice studies to identify theoretical frameworks for interventions. However, few studies identified in our review engaged in research to understand the contextual and site‐specific barriers to a desired behaviour before designing a nudge intervention.

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The challenge of antimicrobial resistance: What economics can contribute

Roope

Smith

Pouwels

et al. 2019

Science

403

247

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As antibiotic consumption grows, bacteria are becoming increasingly resistant to treatment. Antibiotic resistance undermines much of modern health care, which relies on access to effective antibiotics to prevent and treat infections associated with routine medical procedures. The resulting challenges have much in common with those posed by climate change, which economists have responded to with research that has informed and shaped public policy. Drawing on economic concepts such as externalities and the principal–agent relationship, we suggest how economics can help to solve the challenges arising from increasing resistance to antibiotics. We discuss solutions to the key economic issues, from incentivizing the development of effective new antibiotics to improving antibiotic stewardship through financial mechanisms and regulation.

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Nudging to prudence? The effect of reminders on antibiotics prescriptions

Cited by 7 publications

References 4 publications

Physician Behavior and Health Outcomes

Physician Behavior and Health Outcomes

Nudging clinicians: A systematic scoping review of the literature

The challenge of antimicrobial resistance: What economics can contribute

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