Systematic review of interventions to improve prescribing

Ostini, Remo, Hegney, Desley, Jackson, Claire, Williamson, Margaret, Mackson, Judith M., Gurman, Karin, Hall, Wayne and Tett, Susan E. (2009) Systematic review of interventions to improve prescribing. The Annals of Pharmacotherapy, 43 3: 502-513. doi:10.1345/aph.1L488

Author Ostini, Remo
Hegney, Desley
Jackson, Claire
Williamson, Margaret
Mackson, Judith M.
Gurman, Karin
Hall, Wayne
Tett, Susan E.
Title Systematic review of interventions to improve prescribing
Journal name The Annals of Pharmacotherapy   Check publisher's open access policy
ISSN 1060-0280
Publication date 2009-01-01
Year available 2009
Sub-type Article (original research)
DOI 10.1345/aph.1L488
Open Access Status Not Open Access
Volume 43
Issue 3
Start page 502
End page 513
Total pages 12
Editor Whitney, H.
Thordsen, D. S.
Place of publication Cincinnati, OH, United States
Publisher Harvey Whitney Books Company
Language eng
Abstract The number of systematic reviews (SRs) of nursing interventions is increasing in China. Authors of such studies are encouraged to use a risk of bias tool for assessing individual studies. Therefore, it is important to know how these tools have been applied in SRs in Chinese nursing.
Formatted abstract
OBJECTIVE: To update 2 comprehensive reviews of systematic reviews on prescribing interventions and identify the latest evidence about the effectiveness of the interventions.
DATA SOURCES: Systematic searches for English-language reports of experimental and quasi-experimental research were conducted in PubMed (1951–May 2007), EMBASE (1974–March 2008), International Pharmaceutical Abstracts (1970–March 2008), and 11 other bibliographic databases of medical, social science, and business research. Following an initial title screening process and after selecting 6 specific intervention categories (identified from the previous reviews) in community settings, 2 reviewers independently assessed abstracts and then full studies for relevance and quality and extracted relevant data using formal assessment and data extraction tools. Results were then methodically incorporated into the findings of the 2 earlier reviews of systematic reviews.
DATA SELECTION AND SYNTHESIS: Twenty-nine of 26,314 articles reviewed were assessed to be of relevant, high-quality research. Audit and feedback, together with educational outreach visits, were the focus of the majority of recent, highquality research into prescribing interventions. These interventions were also the most effective in improving prescribing practice. A smaller number of studies included a patient-mediated intervention; this intervention was not consistently effective. There is insufficient recent research into manual reminders to confidently update earlier reviews and there remains insufficient evidence to draw conclusions regarding the effectiveness of local consensus processes or multidisciplinary teams.
CONCLUSIONS: Educational outreach as well as audit and feedback continue to dominate research into prescribing interventions. These 2 prescribing interventions also most consistently show positive results. Much less research is conducted into other types of interventions and there is still very little effort to systematically test why interventions do or do not work.
Keyword Academic detailing
Prescribing interventions
Quality improvement
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

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Created: Tue, 05 May 2009, 23:01:46 EST by Vicki Percival on behalf of School of Pharmacy