Patient‐directed strategy to reduce prescribing for patients with dyspepsia in general practice: a randomized trial

Krol, Nicole P. C. M.; Wensing, Michel; Haaijer‐Ruskamp, Flora; Muris, Jean; Numans, Mattijs E.; Schattenberg, G.T.B.M.R.; Balen, J.A. van; Grol, Richard

doi:10.1111/j.1365-2036.2004.01928.x

Cited by 65 publications

(46 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These studies show that in more than 50% of patients on continuous PPI therapy, significant symptoms of gastro-oesophageal reflux disease (GERD) and dyspepsia are present. 4,5 Additionally, trial-based evidence has shown that simple patient-directed intervention is able to reduce longterm PPI use without affecting dyspepsia severity or quality of life. 5 Patients on long-term PPI and without…”

Section: Introductionmentioning

confidence: 99%

Symptoms in patients on long‐term proton pump inhibitors: prevalence and predictors

Raghunath

Hungin

Mason

et al. 2009

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Symptoms in patients on long‐term proton pump inhibitors: prevalence and predictors

Raghunath

Hungin

Mason

et al. 2009

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…We developed and successfully tested a letter of discontinuation for patients. 19 Another study found that some patients with nonspecific low back pain resisted advice to stay physically active and avoid passive physiotherapy. We developed and successfully tested a training session for physicians that included training in communication skills.…”

Section: Linking Interventions To These Barriersmentioning

confidence: 99%

Developing and selecting interventions for translating knowledge to action

Wensing¹,

Bosch²,

Grol³

2009

Canadian Medical Association Journal

Self Cite

172

132

View full text Add to dashboard Cite

E85O nce knowledge has been adapted to local context and the barriers to and facilitators of use of knowledge have been identified, 1 we must select, tailor and implement interventions for the uptake of knowledge. 2This article provides an approach to selecting interventions for knowledge translation.How would we select interventions to translate the knowledge from practice guidelines and research into practice? For example, major variations in the treatment of chronic heart failure have been found repeatedly. In one survey, use of β-blockers in primary care ranged from 10% to 50% between countries, and use of angiotensin-converting enzyme (ACE) inhibitors ranged from 50% to 75%.3 Differences in the recommendations of national guidelines were not sufficient to explain this variation.4 Comorbidity explained some of the variation, but 14% of prescriptions were related to characteristics of patients that were not aligned with evidence.5 A study of barriers to adherence to guidelines related to heart failure showed that many family physicians found it difficult to change treatment initiated by a cardiologist. Titrating the dosage of ACE inhibitors and initiating ACE inhibitors in patients who were already using a diuretic or were stable on their current medication were perceived as barriers. 6Interventions to facilitate the uptake of research could include training for physicians (e.g., to learn about titrating the dosage of ACE inhibitors), the use of opinion leaders to influence patterns of prescribing by cardiologists, or the provision of financial incentives to physicians for each patient with heart failure who is treated according to guidelines. Alternatively, educators could better inform patients and their families about appropriate care in the hope that they will ask for such treatment in future consultations with clinicians. Ideally, the selection of an intervention for knowledge translation should be guided by research-based evidence of the effectiveness and efficiency of the various interventions. However, this evidence cannot explicitly guide our decisions in all situations and circumstances. Therefore, in addition to science, we will need some artistry to choose or design the intervention. A review of all of the evidence on developing and selecting interventions is beyond the scope of this paper; instead we will summarize available systematic reviews. 7,8 Many interventions for knowledge translation have not been well evaluated with rigorous studies. For interventions that have been evaluated, evidence suggests that their impact is variable and, on average, the effect size is moderate.Several conclusions can be drawn from the literature. Available research focuses mainly on professional interventions, such as educational programs, feedback and reminders. The methodological quality is variable but moderate overall. The overall absolute change in professional performance is usually not more than 10% on selected outcomes, but this finding can be clinically or economically relevant.Passive educational inter...

show abstract

“…Also, the preferences of those with mild dementia (who have been shown to be able to express preferences for treatment 43,44 ) need to be studied. Future research should focus on the development of a guide to assist GPs in discussing medication discontinuation with older adults and their carers as well as continued efforts towards education and patient-directed deprescribing interventions (which have shown some effectiveness 45,46 ). In addition, the role of pharmacists and nurses in deprescribing needs to be further explored to facilitate deprescribing in practice.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Beliefs and attitudes of older adults and carers about deprescribing of medications: a qualitative focus group study

Reeve¹,

2016

View full text Add to dashboard Cite

Patient‐directed strategy to reduce prescribing for patients with dyspepsia in general practice: a randomized trial

Cited by 65 publications

References 13 publications

Symptoms in patients on long‐term proton pump inhibitors: prevalence and predictors

Symptoms in patients on long‐term proton pump inhibitors: prevalence and predictors

Developing and selecting interventions for translating knowledge to action

Beliefs and attitudes of older adults and carers about deprescribing of medications: a qualitative focus group study

Contact Info

Product

Resources

About