Effect of periodic letters on evidence-based drug therapy on prescribing behaviour: a randomized trial

Improving the Success of Mailed Letter Intervention Programs to Influence Prescribing Behaviors: A Review

“…Programs that mailed interventions to prescribers based solely on practice location typically had little to no impact. 5,6,28,30,32,[43][44][45] This is consistent with the findings by Figueiras et al (2001), who concluded that interventions that were personalized to recipients were associated with a higher rate of success. 34 If costs permit, addition of pharmacists and/or patients as recipients may further improve intervention success.…”

“…Programs (n = 8) that selected prescribers based on geographic location rather than prescribing behavior were found to have little to no impact on prescribing patterns. 5,6,28,30,32,[43][44][45] In addition to targeting prescribers, several programs (n = 6) also sent correspondence to pharmacies involved in the care of identified patients. 8,[13][14][15]22,23,46 Jing et al (2011) was the only identified program that included both prescribers and patients as intervention recipients.…”

“…19 Three programs that targeted an extensive list of unrelated medications and/or disease states had minimal impact on prescribing behavior. 28,43,44 The exception to using broad targets is Groves, who successfully used patient-specific recommendations to evoke change in prescribing among patients identified as atrisk for drug-related adverse effects. 15 Several authors noted that it may be difficult to prompt discontinuation of agents that have been used on a long-term basis; this may be particularly true for sedative hypnotics.…”

“…5,28,29,32 Additionally, each of the 4 programs that provided educational materials alone were found to have little to no impact on measured outcomes. 24,44,50,51 It should be noted that one program that reported positive outcomes used prescriber feedback in combination with patientidentifying data and educational material. 23 Along with providing educational material for prescribers, several programs also included supplemental educational material for patients.…”

“…Continuous mailings of educational material or prescriber feedback alone often had minimal impact on prescribing patterns. 6,31,44,45 Conversely, multiple mailings that contained patient-identifying data and/or a combination of intervention materials had a higher success rate. [2][3][4]16,27,31 Among these, two programs found mailings sent on a quarterly basis to be associated with continuous significant improvements in prescribing throughout the entire study period.…”