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Changing prescribing behaviours with educational outreach: an overview of evidence and practice

机译:改变教育外展的处方行为:证据概述和实践概述

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摘要

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.
机译:摘要背景全科医生(GPS)或家庭从业者是任务,这些药物有权对社区有害的药物,如果它们不恰当地规定或使用(例如阿片类药物)。教育计划,如教育外展(EO),旨在改变健康专业人士的行为。本研究的目的是确定EO计划在改变GPS的规定行为时的效果。方法本研究包括证据和实践审查,包括迅速审查,该综述补充了与熟悉监管目的的EO实施的人的访谈。使用与健康专业人士和处方相关的条款进行搜索七个数据库。包括在2007年后发表英语的系统和叙述评论。非统计分析用于报告干预效果。三名政府代表参加了半结构化访谈,以帮助了解审查结果对维多利亚方面的相关性。采访被转录逐字并对新兴主题进行主题分析。结果14条评论被确定为证据审查。被发现和多方面(例如由其他干预措施提供的EO计划)和多方面(例如,补充的EO计划)计划改变处方行为。但是,有限的证据表明EO可以成功地改变特定于GPS的规定行为。孤立的EO可以成功地改变健康专业规定行为,尽管诸如字母等更便宜的替代方案可能同样有效。多方面的EO也可以成功地改变健康专业规定行为,特别是在老年人身上,但它仍然尚不清楚干预措施的结合最佳。政府代表报告的EO成功因素包括具有实用而非教学症的方案;制作EO强制性;重点关注eo预防不良事件;使用货币或专业发展激励措施;和人交付。结论教育外展可以成功改变规定行为,但缺乏针对GPS的证据。可以优化成功的EO的关键特征包括确保EO计划量身定制,涉及实际学习,并使用对临床医生有意义的激励措施。

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