Detailed postal feedback about prescribing to asthma patients combined with a guideline statement showed no impact: a randomised controlled trial
Abstract
Objective To evaluate the effects of postal feedback with clinically relevant data on general practitioners' prescribing compared with feedback with aggregate data on prescribing patterns of asthma drugs. Methods The study was a randomised, controlled trial. The general practitioners (GPs) in the County of Funen, Denmark (292 GPs representing 178 practices) were randomised to one of three groups receiving different forms of prescriber feedback. The first group received detailed and clinically relevant data on asthma drug prescribing patterns and a guideline statement. These data included tables with counts of asthma patients following classification of each individual's consumption of inhaled beta2-agonists and use of inhaled steroids. The second group received aggregate data on asthma drug prescribing patterns and a guideline statement, and the third group received feedback on an unrelated subject and served as control for the other groups. Each GP received prescriber feedback three times within a 6-month period. The last two letters with prescriber feedback had updated information with the purpose of showing changes in prescribing patterns. Effects were followed for a period of 1 year. The main outcome measures were change in fraction of asthmatics treated with inhaled steroids and incidence rate of treatment with inhaled steroids. Results The three groups had similar baseline characteristics. None of the two types of feedback on prescribing of asthma drugs had a statistically significant impact on GPs' prescribing patterns. Conclusion Mailed prescriber feedback of detailed and clinically relevant data with a guideline statement, without revealing patient identities, has little or no impact on prescribing patterns.
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There is conflicting evidence regarding the role of peer-comparison in feedback.
“there is conflicting evidence regarding the role of peer‐comparison in feedback (Kiefe 2001; Søndergaard 2002; Wones 1987).”
From Audit and feedback: effects on professional practice and healthcare outcomes (2012) · cites this paper as Søndergaard 2002
Søndergaard 2002 found a small difference when adding peer comparison data to audit and feedback for asthma management (adjusted RD = 2%).
“Søndergaard 2002 and Wones 1987 each found small differences when adding peer comparison data to the audit and feedback for asthma management (adjusted RD = 2%) or inpatient laboratory test utilisation (adjusted change relative to baseline control = 5%), respectively.”
From Audit and feedback: effects on professional practice and healthcare outcomes (2012) · cites this paper as Søndergaard 2002
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- Authors
- Søndergaard, J., Andersen, M., Vach, K., Kragstrup, J., Maclure, M., & Gram, L. F.
- Affiliations
- University of Southern Denmark (DK)
- Venue
- European Journal of Clinical Pharmacology
- Published
- 2002-04-17
- Volume
- 58
- Issue
- 2
- Pages
- 127-132
- ISSN
- 0031-6970 (ISSN-L)
- 1432-1041
- OpenAlex
- W2058444266
- Cited by
- 44
- References
- 24
- Citations by year
- 2025: 2 · 2022: 1 · 2020: 2 · 2019: 1 · 2018: 1 · 2016: 1 · 2015: 2 · 2013: 4 · 2012: 6
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Journal of Clinical Pharmacology (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Keywords
- prescriber feedback, asthma, general practitioners, prescribing patterns, inhaled beta2-agonists, inhaled corticosteroids, guideline adherence, primary care
- MeSH terms
- Adolescent, Adrenal Cortex Hormones, Adrenergic beta-Agonists, Adult, Asthma, Child, Denmark, Family Practice, Feedback, Humans, Middle Aged, Practice Patterns, Physicians', Postal Service, Practice Guidelines as Topic
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