Changing prescribing behaviours with educational outreach: an overview of evidence and practice
Abstract Background General practitioners (GPs), or family practitioners, are tasked with prescribing medications that can be harmful to the community if they are inappropriately prescribed or used (e.g. opioids). Educational programs, such as educational outreach (EO), are designed to change the be...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12909-019-1735-3 |
| _version_ | 1818982088724971520 |
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| author | Breanne E. Kunstler Alyse Lennox Peter Bragge |
| author_facet | Breanne E. Kunstler Alyse Lennox Peter Bragge |
| author_sort | Breanne E. Kunstler |
| collection | DOAJ |
| description | Abstract Background General practitioners (GPs), or family practitioners, are tasked with prescribing medications that can be harmful to the community if they are inappropriately prescribed or used (e.g. opioids). Educational programs, such as educational outreach (EO), are designed to change the behaviour of health professionals. The purpose of this study was to identify the efficacy of EO programs at changing the prescribing behaviour of GPs. Methods This study included an evidence and practice review, comprising a rapid review supplemented by interviews with people who are familiar with EO implementation for regulation purposes. Seven databases were searched using terms related to health professionals and prescribing. Systematic and narrative reviews published in English after 2007 were included. Non-statistical analysis was used to report intervention efficacy. Three government representatives participated in semi-structured interviews to aid in understanding the relevance of review findings to the Victorian context. Interviews were transcribed verbatim and thematically analysed for emerging themes. Results Fourteen reviews were identified for the evidence review. Isolated (e.g. EO program delivered by itself) and multifaceted (e.g. EO program supplemented by other interventions) programs were found to change prescribing behaviours. However, limited evidence suggests that EO can successfully change prescribing behaviours specific to GPs. Isolated EO can successfully change health professional prescribing behaviours, although cheaper alternatives such as letters might be just as effective. Multifaceted EO can also successfully change health professional prescribing behaviours, especially in older adults, but it remains unclear as to what combination of interventions works best. Success factors for EO reported by government representatives included programs having practical rather than didactic foci; making EO compulsory; focussing EO on preventing adverse events; using monetary or professional development incentives; and in-person delivery. Conclusions Educational outreach can successfully change prescribing behaviours but evidence specific to GPs is lacking. Key characteristics of EO that could optimise success include ensuring the EO program is tailored, involves practical learning and uses incentives that are meaningful to clinicians. |
| first_indexed | 2024-12-20T17:41:40Z |
| format | Article |
| id | doaj.art-e33dea6379f941669c36eba2c7e7519b |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-12-20T17:41:40Z |
| publishDate | 2019-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-e33dea6379f941669c36eba2c7e7519b2022-12-21T19:31:06ZengBMCBMC Medical Education1472-69202019-08-0119112010.1186/s12909-019-1735-3Changing prescribing behaviours with educational outreach: an overview of evidence and practiceBreanne E. Kunstler0Alyse Lennox1Peter Bragge2BehaviourWorks Australia, Monash Sustainable Development Institute, Monash UniversityBehaviourWorks Australia, Monash Sustainable Development Institute, Monash UniversityBehaviourWorks Australia, Monash Sustainable Development Institute, Monash UniversityAbstract Background General practitioners (GPs), or family practitioners, are tasked with prescribing medications that can be harmful to the community if they are inappropriately prescribed or used (e.g. opioids). Educational programs, such as educational outreach (EO), are designed to change the behaviour of health professionals. The purpose of this study was to identify the efficacy of EO programs at changing the prescribing behaviour of GPs. Methods This study included an evidence and practice review, comprising a rapid review supplemented by interviews with people who are familiar with EO implementation for regulation purposes. Seven databases were searched using terms related to health professionals and prescribing. Systematic and narrative reviews published in English after 2007 were included. Non-statistical analysis was used to report intervention efficacy. Three government representatives participated in semi-structured interviews to aid in understanding the relevance of review findings to the Victorian context. Interviews were transcribed verbatim and thematically analysed for emerging themes. Results Fourteen reviews were identified for the evidence review. Isolated (e.g. EO program delivered by itself) and multifaceted (e.g. EO program supplemented by other interventions) programs were found to change prescribing behaviours. However, limited evidence suggests that EO can successfully change prescribing behaviours specific to GPs. Isolated EO can successfully change health professional prescribing behaviours, although cheaper alternatives such as letters might be just as effective. Multifaceted EO can also successfully change health professional prescribing behaviours, especially in older adults, but it remains unclear as to what combination of interventions works best. Success factors for EO reported by government representatives included programs having practical rather than didactic foci; making EO compulsory; focussing EO on preventing adverse events; using monetary or professional development incentives; and in-person delivery. Conclusions Educational outreach can successfully change prescribing behaviours but evidence specific to GPs is lacking. Key characteristics of EO that could optimise success include ensuring the EO program is tailored, involves practical learning and uses incentives that are meaningful to clinicians.http://link.springer.com/article/10.1186/s12909-019-1735-3EducationAcademic detailingEducational outreachGeneral practicePrimary careInappropriate prescribing |
| spellingShingle | Breanne E. Kunstler Alyse Lennox Peter Bragge Changing prescribing behaviours with educational outreach: an overview of evidence and practice BMC Medical Education Education Academic detailing Educational outreach General practice Primary care Inappropriate prescribing |
| title | Changing prescribing behaviours with educational outreach: an overview of evidence and practice |
| title_full | Changing prescribing behaviours with educational outreach: an overview of evidence and practice |
| title_fullStr | Changing prescribing behaviours with educational outreach: an overview of evidence and practice |
| title_full_unstemmed | Changing prescribing behaviours with educational outreach: an overview of evidence and practice |
| title_short | Changing prescribing behaviours with educational outreach: an overview of evidence and practice |
| title_sort | changing prescribing behaviours with educational outreach an overview of evidence and practice |
| topic | Education Academic detailing Educational outreach General practice Primary care Inappropriate prescribing |
| url | http://link.springer.com/article/10.1186/s12909-019-1735-3 |
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