Does a joint development and dissemination of multidisciplinary guidelines improve prescribing behaviour: a pre/post study with concurrent control group and a randomised trial

BACKGROUND: It is difficult to keep control over prescribing behaviour in general practices. The purpose of this study was to assess the effects of a dissemination strategy of multidisciplinary guidelines on the volume of drug prescribing. METHODS: The study included two designs, a quasi-experimental pre/post study with concurrent control group and a random sample of GPs within the intervention group. The intervention area with 53 GPs was compared with a control group of 54 randomly selected GPs in the south and centre of the Netherlands. Additionally, a randomisation was executed in the intervention group to create two arms with 27 GPs who were more intensively involved in the development of the guideline and 26 GPs in the control group. A multidisciplinary committee developed prescription guidelines. Subsequently these guidelines were disseminated to all GPs in the intervention region. Additional effects were studied in the subgroup trial in which GPs were invited to be more intensively involved in the guideline development procedure. The guidelines contained 14 recommendations on antibiotics, asthma/COPD drugs and cholesterol drugs The main outcome measures were prescription data of a three-year period (one year before and 2 years after guideline dissemination) and proportion of change according to recommendations. RESULTS: Significant short-term improvements were seen for one recommendation: mupirocin. Long-term changes were found for cholesterol drug prescriptions. No additional changes were seen for the randomised controlled study in the subgroup. GPs did not take up the invitation for involvement. CONCLUSION: Disseminating multidisciplinary guidelines that were developed within a region, has no clear effect on prescribing behaviour even though GPs and specialists were involved more intensively in their development. Apparently, more effort is needed to bring about change

Effectiveness and costs of implementation strategies to reduce acid suppressive drug prescriptions: a systematic review

<p>Abstract</p> <p>Background</p> <p>Evaluation of evidence for the effectiveness of implementation strategies aimed at reducing prescriptions for the use of acid suppressive drugs (ASD).</p> <p>Methods</p> <p>A systematic review of intervention studies with a design according to research quality criteria and outcomes related to the effect of reduction of ASD medication retrieved from Medline, Embase and the Cochrane Library. Outcome measures were the strategy of intervention, quality of methodology and results of treatment to differences of ASD prescriptions and costs.</p> <p>Results</p> <p>The intervention varied from a single passive method to multiple active interactions with GPs. Reports of study quality had shortcomings on subjects of data-analysis. Not all outcomes were calculated but if so rction of prescriptions varied from 8% up to 40% and the cost effectiveness was in some cases negative and in others positive. Few studies demonstrated good effects from the interventions to reduce ASD.</p> <p>Conclusion</p> <p>Poor quality of some studies is limiting the evidence for effective interventions. Also it is difficult to compare cost-effectiveness between studies. However, RCT studies demonstrate that active interventions are required to reduce ASD volume. Larger multi-intervention studies are necessary to evaluate the most successful intervention instruments.</p

Stichting Farmaceutische Kengetallen

De Stichting Farmaceutische Kengetallen (SFK) houdt zich sinds 1990 bezig met het verzamelen en analyseren van gedetailleerde gegevens omtrent het geneesmiddelengebruik in Nederland. De SFK betrekt haar informatie rechtstreeks van ruim 98% van alle openbare apotheken in ons land. Deze apotheken bedienen samen 16 miljoen Nederlanders die genees-, verband- of hulpmiddelen verstrekt krijgen. Per verstrekking registreert de SFK gegevens van het middel dat is afgeleverd de apotheek die het middel verstrekt heeft de zorgverzekeraar die de verstrekking al of niet heeft vergoed de arts die het middel heeft voorgeschreven de patiënt die het middel voorgeschreven heeft gekregen De SFK verzamelt uitsluitend patiëntgegevens die gebaseerd zijn op een volgnummer dat aan patiënten door het apotheekinformatiesysteem van de apotheek wordt toegekend. Het is op basis van deze gegevens voor de SFK niet mogelijk om de geneesmiddelen die aan dezelfde persoon in verschillende apotheken zijn verstrekt aan elkaar te koppelen. Om de gegevens van personen in verschillende apotheken wel te kunnen combineren met inachtneming van de anonimiteit van de patiënten, werkt de SFK samen met ZorgTTP. Van ZorgTTP ontvangt de SFK pseudoniemen van apotheekbezoekers die de SFK wel in staat stelt om patiënten anoniem over verschillende apotheken te volgen. De identiteit van patiënten blijft altijd voor de SFK onbekend

A nationwide cross-sectional survey of pharmacy students on pharmacogenetic testing in The Netherlands

Personalised Therapeutic

Interchangeability of Generic Drugs: A Nonparametric Pharmacokinetic Model of Gabapentin Generic Drugs

Item does not contain fulltex

The economic impact of high-need psoriasis in daily clinical practice before and after the introduction of biologics.

Contains fulltext : 88933.pdf (publisher's version ) (Closed access)Background Although costs of biologics are high, effective treatment of patients with psoriasis may reduce the total health care costs, as it may limit the need for hospitalization. Objectives To investigate the economic impact of psoriasis, including direct costs, before and after the introduction of biologics, with special focus on hospitalized patients, treatment effectiveness and patient satisfaction with medication. Patients and methods A descriptive retrospective cohort study including 67 patients with high-need psoriasis was done. Direct costs were investigated for the biologic and pre-biologic period. Direct costs for a subgroup of hospitalized patients were analysed separately. Patient satisfaction with biologic treatment was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM) version II. Effectiveness of biologic therapy was investigated by means of the Psoriasis Area and Severity Index (PASI). Results Mean total direct costs were euro10 146 per patient per year (PPPY) in the pre-biologic treatment period, compared with euro17 712 PPPY in the biologic treatment period. For six patients in the cohort, introduction of biologics led to a reduction of direct costs, as these patients did not need long hospitalizations. Treatment with biologics led to a decrease in PASI from 19.0 at the start of biologic therapy to 6.4 at analysis (66.4%). Patient satisfaction with biologics was high, indicated by a mean TSQM score of 77.8. Conclusions Introduction of biologic therapies may have cost-neutral or cost-saving effects for patients who otherwise require long hospitalization periods. Treatment with biologics proved effective and was accompanied by high satisfaction for the patients.1 juni 201