Literature DB >> 12390556

Modifying provider behavior: a low-tech approach to pharmaceutical ordering.

Jeffrey J Guterman1, Bruce A Chernof, Beatriz Mares, Sandra G Gross-Schulman, Pramod G Gan, Donald Thomas.   

Abstract

OBJECTIVE: To determine if a clinically structured, paper-based prescription form can modify pharmaceutical prescribing behavior without restricting physician freedom to select the most appropriate medication for an individual patient.
DESIGN: Uncontrolled, nonrandomized, time series design.
SETTING: The urgent care clinic of a university-affiliated, county-supported hospital that provides care for underserved, vulnerable populations. PATIENTS: Patients (N = 2189) who had a prescription written at the intervention site during the study. INTERVENTION: Four-phase interventions lasting 2 weeks each, with a washout period between each phase, consisting of: (1). collection of baseline data utilizing the traditional prescription blank, (2). introduction of the pre-formatted prescription form, (3). use of the pre-formatted prescription form with medication cost added, and (4). pre-formatted prescription form with target drug (ranitidine) removed.
MEASUREMENTS AND MAIN RESULTS: Physicians were less likely to prescribe ranitidine compared to cimetidine after the introduction of the cost information (P <.01) and again after the removal of ranitidine from the pre-formatted prescription form (P <.001).
CONCLUSIONS: A structured, paper-based prescription order form can shift prescribing practices without inhibiting physicians' ordering freedom.

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Year:  2002        PMID: 12390556      PMCID: PMC1495115          DOI: 10.1046/j.1525-1497.2002.20144.x

Source DB:  PubMed          Journal:  J Gen Intern Med        ISSN: 0884-8734            Impact factor:   5.128


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