Open AccessModifying Provider Behavior
Author(s) -
Guterman Jeffrey J.,
Chernof Bruce A.,
Mares Beatriz,
GrossSchulman Sandra G.,
Gan Pramod G.,
Thomas Donald
Publication year - 2002
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1046/j.1525-1497.2002.20144.x
Subject(s) - medicine , family medicine
OBJECTIVE: To determine if a clinically structured, paper‐based prescription form can modify pharmaceutical prescribing behavior without restricting physician freedom to select the most appropriate medication for an individual patient. DESIGN: Uncontrolled, nonrandomized, time series design. SETTING: The urgent care clinic of a university‐affiliated, county‐supported hospital that provides care for underserved, vulnerable populations. PATIENTS: Patients ( N = 2,189) who had a prescription written at the intervention site during the study. INTERVENTION: Four‐phase interventions lasting 2 weeks each, with a washout period between each phase, consisting of: (1) collection of baseline data utilizing the traditional prescription blank, (2) introduction of the pre‐formatted prescription form, (3) use of the pre‐formatted prescription form with medication cost added, and (4) pre‐formatted prescription form with target drug (ranitidine) removed. MEASUREMENTS AND MAIN RESULTS: Physicians were less likely to prescribe ranitidine compared to cimetidine after the introduction of the cost information ( P < .01) and again after the removal of ranitidine from the pre‐formatted prescription form ( P < .001). CONCLUSIONS: A structured, paper‐based prescription order form can shift prescribing practices without inhibiting physicians' ordering freedom.