Quality circles to improve prescribing patterns in primary medical care: what is their actual impact?

Wensing, Michel; Broge, Björn; Kaufmann‐Kolle, Petra; Andres, Editha; Szécsényi, Joachim

doi:10.1111/j.1365-2753.2004.00517.x

Cited by 43 publications

(62 citation statements)

References 20 publications

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“…Pearson correlation was used to assess the determinants of override behavior by examining the relationships among the number of prescriptions, number of alerts, override ratio, and number of encounters. We hypothesized that a large number of encounters would cause a large number of medication prescriptions based on the finding that 76 ~81% of patient visits received a drug prescription in a primary care setting [23] ,which would increase the probability of triggering alerts and overriding them. The provider characteristics were compared using the t-test, chi-square statistic, and Fisher's exact test.…”

Section: Discussionmentioning

confidence: 99%

The effect of provider characteristics on the responses to medication-related decision support alerts

Cho

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Nanji

et al. 2015

International Journal of Medical Informatics

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. (2015) 'The eect of provider characteristics on the responses to medication-related decision support alerts.', International journal of medical informatics., 84 (9). pp. 630-639. Further information on publisher's website: Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Page 1 of 31A c c e p t e d M a n u s c r i p t

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Section: Discussionmentioning

confidence: 99%

The effect of provider characteristics on the responses to medication-related decision support alerts

Cho

Slight

Nanji

et al. 2015

International Journal of Medical Informatics

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“…All used secondary data from prescription records and drug sales. A study was conducted in a high-middle-income country 16 and 16 in high-income countries 3,17,25,26,[30][31][32][35][36][37][38][39][40][41][42] . The selected designs were two RCTs, five NRCTs, seven CBAs and three ITS.…”

Section: Evidence Quality Evaluationmentioning

confidence: 99%

“…The selected designs were two RCTs, five NRCTs, seven CBAs and three ITS. The interventions were found to be educational 3,[16][17][18]25,26,[30][31][32]35 , of financial incentive 4,32,36,37 , electronic prescription 38,39 and managerial 40 . The main characteristics of the studies are summarized in Chart 1.…”

Section: Evidence Quality Evaluationmentioning

confidence: 99%

“…Niquille et al 25 , Wensing et al 30 , Rausell Rausell et al 17 , Calvo Alcántara et al 3 Rausell Rausell et al 17 evaluated the effect of personalized monthly reports containing pre- Moderate Small increase It is likely that the educational intervention has affected the pharmacist, but this effect has been minimal.…”

Section: Educational Interventionsmentioning

confidence: 99%

“…These studies 3,[16][17][18]25,26,[30][31][32] showed small to medium impact, always favorable to generic prescription, but with very low quality evidence (Chartes 2 and 3).…”

Section: Change In User's Behaviormentioning

confidence: 99%

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Impacto de intervenções para promoção do uso de medicamentos genéricos: revisão sistemática

Guttier

Silveira²,

Luiza

et al. 2017

Ciênc. saúde coletiva

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Case management of arthritis patients in primary care: A cluster‐randomized controlled trial

Rosemann¹,

Joos²,

Laux³

et al. 2007

Arthritis & Rheumatism

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Objective. To assess whether providing information on arthritis self-management through general practitioners (GPs) increases the quality of life in patients with osteoarthritis and whether additional case management provided by practice nurses shows better results. Methods. We conducted a pragmatic, cluster-randomized, controlled, 3-arm trial that included 1,021 patients from 75 primary care practices in Germany. GPs were randomized to intervention group I, group II, or a control group. GPs of both intervention groups participated in 2 peer group meetings. In intervention group II, additional case management was conducted via telephone by a practice nurse. The primary outcome was change in quality of life, assessed by the German version of the Arthritis Impact Measurement Scales Short Form (AIMS2-SF). Secondary outcomes were health service utilization, prescriptions, and physical activity. Data were controlled for depression using the Patient Health Questionnaire 9 as a potential confounder. Results. Of 1,125 administered questionnaires, 1,021 were analyzed. Compared with the control group, no significant changes occurred in intervention group I with respect to the primary outcome. Performed radiographs decreased significantly (P ‫؍‬ 0.050), whereas prescriptions of acetaminophen increased significantly (P < 0.001). In intervention group II, significant changes in the AIMS2-SF dimensions social (P < 0.001), symptom (P ‫؍‬ 0.048), and lower body (P ‫؍‬ 0.049) were identified. Radiographs (P ‫؍‬ 0.031) and orthopedic referrals (P ‫؍‬ 0.044) decreased whereas prescriptions of pain relievers increased significantly. Conclusion. Improving the quality of life in patients with arthritis using arthritis self-management seems challenging. Simply providing this information through GPs is not sufficient but combining it with case management seems to be a promising approach.

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Quality circles to improve prescribing patterns in primary medical care: what is their actual impact?

Abstract: Large-scale application of quality circles had intended effects on prescribing decisions in primary care in Germany. The effects found in this study may reflect better what improvements can be achieved than randomized trials of similar interventions.

Cited by 43 publications

References 20 publications

The effect of provider characteristics on the responses to medication-related decision support alerts

The effect of provider characteristics on the responses to medication-related decision support alerts

Impacto de intervenções para promoção do uso de medicamentos genéricos: revisão sistemática

Case management of arthritis patients in primary care: A cluster‐randomized controlled trial

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