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Quantitative evaluation of a clinical intervention aimed at changing prescriber behaviour in response to new guidelines
Author(s) -
Doyon Sophie,
Perreault Mélissa,
Marquis Christopher,
Gauthier Josianne,
Lebel Denis,
Bailey Benoit,
Collin Johanne,
Bussières JeanFrançois
Publication year - 2009
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2009.01259.x
Subject(s) - medicine , intervention (counseling) , medical prescription , guideline , family medicine , community acquired pneumonia , pneumonia , emergency medicine , nursing , pathology
Rational, aims and objectives The objective of the study was to assess prescribers' compliance with guidelines for acute community‐acquired pneumonia management in a paediatric university hospital centre before and after its dissemination. Method This quasi‐experimental study without a control group was conducted before and after new community‐acquired pneumonia management guidelines were disseminated in a tertiary care paediatric hospital. The pre‐intervention (baseline) period was from October 2004 to March 2005. The intervention period was divided into two phases: (1) October 2005 to January 14, 2006 (consultation by peer leaders and networking) and (2) January 15, 2006, to March 2006 (dissemination of official guidelines and of a pre‐printed prescription sheet, an educational session led by a peer leader for residents and further networking). We used a compliance score to assess prescriptions written by prescribers who practised in the units where the guidelines had to be followed. Results The study included a total of 1151 prescriptions. The prescription compliance with the guidelines increased from 131/652 (20.1%) in the pre‐intervention period to 264/499 (52.9%) in the post‐intervention intervention period: a difference of 32.8% (CI 95% 27.4–38.0). Similar results were found if analysed according to affiliation (emergency department or wards). An inappropriate choice of antibiotic agent represented 347/521 (66.6%) of the causes of non‐compliance in the pre‐intervention period and 99/235 (42.1) in the intervention period: a difference of −24.5% (95% CI −31.8, −16.8). Conclusion Guideline dissemination for the management of acute community‐acquired pneumonia significantly increased prescriber compliance in the emergency department and on wards.