Improving Drug Prescribing in Primary Care: A Critical Analysis of the Experimental Literature

Transferring scientific evidence to oncological practice: a trial on the impact of three different implementation strategies on antiemetic prescriptions

“…On the other hand, the rate of inappropriate prescription of a 5HT 3 antagonist, alone or in combination, for the prevention of acute emesis induced by low emetogenic chemotherapy, was even greater (from 47.7 to 65.7%, P<0.0001). These findings confirm the results of a previous systematic review in which the dissemination of printed educational material alone was found ineffective in all adequately controlled trials, whereas positive effects were reported in all uncontrolled studies [7]. A similar poor result was achieved in the 13 centers randomized to receive a combination of two implementation strategies: the simple diffusion of guidelines and the information on their prescription pattern on antiemetics collected in a DU study in 1996 (audit and feedback implementation strategy).…”

“…The low effectiveness of the audit and feedback strategy shown in our study is apparently in contrast with previous results obtained in a primary care setting [1,7] and is not attributable to variations in the oncological staff; however, a possible "dilution effect" cannot be excluded, since the feedback was not provided in an "ongoing way," as in previous studies [1].…”

Falling on stony ground? A qualitative study of implementation of clinical guidelines’ prescribing recommendations in primary care

“…Most prescribing costs happen in primary care [6]. Soumerai et al estimated that about 75% of visits to office-based doctors end up in prescribing [7]. In 1995, GP prescribing amounted to 11% of total NHS spending [8].…”

Antibiotic use: How to improve it?

“…a pharmacist), who give explanations and provide support on a one-to-one basis (e.g. Soumerai et al, 1989;Thomson et al, 1998). Serious reductions in prescribing are being reported as a result (10-30%).…”