Rocío López-Sepúlveda1, María Ángeles García Lirola2, Esther Espínola García1, Salvadora Martín Sances1, Sonia Anaya Ordóñez1, José María Jurado Martínez1, José Cabeza Barrera3. 1. Unidad Gestión Clínica de Farmacia Provincial de Granada, Distrito Sanitario Granada Metropolitano, Instituto de Investigación Biosanitaria ibs. GRANADA, Hospitales Universitarios de Granada - Universidad de Granada, Granada, Spain. 2. Unidad Gestión Clínica de Farmacia Provincial de Granada, Distrito Sanitario Granada Metropolitano, Instituto de Investigación Biosanitaria ibs. GRANADA, Hospitales Universitarios de Granada - Universidad de Granada, Granada, Spain. mariaa.garcia.lirola.sspa@juntadeandalucia.es. 3. Unidad de Gestión Clínica de Farmacia Provincial de Granada, Complejo Hospitalario de Granada, Instituto de Investigación Biosanitaria ibs. GRANADA, Hospitales Universitarios de Granada - Universidad de Granada., Granada, Spain.
Abstract
PURPOSE: The objective of this study was to measure the impact of an intervention on the prescription habits of general practitioners (GPs) in order to improve the quality of zolpidem prescriptions in patients aged 75 or older. METHODS: A prospective multicentric non-randomized trial was performed in the Metropolitan Granada Primary Healthcare Area (Andalusian Public Healthcare Service, Spain), which serves a total population of approximately 675,000 inhabitants. All health centers volunteering to participate in the trial were included. The intervention consisted of training sessions, individualized feedback, clinical information, and financial incentives. A daily dose over 5 mg was considered non-safe. Reduction in non-safe prescriptions of zolpidem in the elderly population became a quality prescribing indicator in a pay-for-performance scheme. RESULTS: Statistically significant differences versus baseline were found between the intervention and control groups in mean zolpidem prescription prevalence (28.5 vs. 37.5‰, respectively; p = 0.008) and mean non-safe zolpidem prescription prevalence (16.5 vs. 34.2‰, respectively; p < 0.001). At the end of the study period, the total number of non-safe prescriptions was 1309, 35% lower versus baseline, with a significant difference of p < 0.001; the number in the intervention (510 vs. 1118; p < 0.001) and control (799 vs. 893; p = 0.0064) groups was also significantly lower, with a significantly greater percentage reduction in the intervention group (54.4 vs. 10.5%, p < 0.001). CONCLUSION: The quality prescribing indicator in our area was improved by the intervention developed. Further studies that include an intervention group of GPs who receive no financial incentive are required to evaluate the relative importance of an economic reward in achieving this improvement.
RCT Entities:
PURPOSE: The objective of this study was to measure the impact of an intervention on the prescription habits of general practitioners (GPs) in order to improve the quality of zolpidem prescriptions in patients aged 75 or older. METHODS: A prospective multicentric non-randomized trial was performed in the Metropolitan Granada Primary Healthcare Area (Andalusian Public Healthcare Service, Spain), which serves a total population of approximately 675,000 inhabitants. All health centers volunteering to participate in the trial were included. The intervention consisted of training sessions, individualized feedback, clinical information, and financial incentives. A daily dose over 5 mg was considered non-safe. Reduction in non-safe prescriptions of zolpidem in the elderly population became a quality prescribing indicator in a pay-for-performance scheme. RESULTS: Statistically significant differences versus baseline were found between the intervention and control groups in mean zolpidem prescription prevalence (28.5 vs. 37.5‰, respectively; p = 0.008) and mean non-safe zolpidem prescription prevalence (16.5 vs. 34.2‰, respectively; p < 0.001). At the end of the study period, the total number of non-safe prescriptions was 1309, 35% lower versus baseline, with a significant difference of p < 0.001; the number in the intervention (510 vs. 1118; p < 0.001) and control (799 vs. 893; p = 0.0064) groups was also significantly lower, with a significantly greater percentage reduction in the intervention group (54.4 vs. 10.5%, p < 0.001). CONCLUSION: The quality prescribing indicator in our area was improved by the intervention developed. Further studies that include an intervention group of GPs who receive no financial incentive are required to evaluate the relative importance of an economic reward in achieving this improvement.
Entities:
Keywords:
Elderly; General practitioners; Physician incentive plans; Physician’s practice pattern; Zolpidem
Authors: Rikje Ruiter; Loes E Visser; Myrthe P P van Herk-Sukel; Petronella H Geelhoed-Duijvestijn; Sandra de Bie; Sabine M J M Straus; Peter G M Mol; Silvana A Romio; Ron M C Herings; Bruno H Ch Stricker Journal: Drug Saf Date: 2012-06-01 Impact factor: 5.606
Authors: Melissa M Garrido; Holly G Prigerson; Joan D Penrod; Shatice C Jones; Kenneth S Boockvar Journal: Clin Ther Date: 2014-11-04 Impact factor: 3.393
Authors: Jonathan L Harward; Valerie B Clinard; Michael R Jiroutek; Beverly H Lingerfeldt; Andrew J Muzyk Journal: Prim Care Companion CNS Disord Date: 2015-03-05
Authors: Vishal Ahuja; Min-Woong Sohn; John R Birge; Chad Syverson; Elly Budiman-Mak; Nicholas Emanuele; Jennifer M Cooper; Elbert S Huang Journal: J Manag Care Spec Pharm Date: 2015-12