ArticleBMC health services research2009
Do decision support systems influence variation in prescription?
Article in BMC health services research, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of electronic medical record on physician practice in office settings: a systematic review.BMC medical informatics and decision making · 2012Pooled it
- Reducing antibiotic prescriptions for respiratory tract infections in family practice: results of a cluster randomized controlled trial evaluating a multifaceted peer-group-based intervention.NPJ primary care respiratory medicine · 2016Trial
- Causes of regional variation in Dutch healthcare expenditures: Evidence from movers.Health economics · 2019Article
- The impact of Medicare part D prescription drug benefit program on generic drug prescription: A study in long-term care facilities.Medicine · 2019Observational
- Influences on the start, selection and duration of treatment with antibiotics in long-term care facilities.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017Article
- Is Customization in Antidepressant Prescribing Associated with Acute-Phase Treatment Adherence?Journal of pharmaceutical health services research : an official journal of the Royal Pharmaceutical Society of Great Britain · 2012Article
- Practice variation in a longitudinal perspective: a multilevel analysis of the prescription of simvastatin in general practices between 2003 and 2009.European journal of clinical pharmacology · 2011Article
- Potential value of electronic prescribing in health economic and outcomes research.Patient related outcome measures · 2010Article
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundTranslating scientific evidence into daily practice is problematic. All kinds of intervention strategies, using educational and/or directive strategies, aimed at modifying behavior, have evolved, but have been found only partially successful. In this article the focus is on (computerized) decision support systems (DSSs). DSSs intervene in physicians' daily routine, as opposed to interventions that aim at influencing knowledge in order to change behavior. We examined whether general practitioners (GPs) are prescribing in accordance with the advice given by the DSS and whether there is less variation in prescription when the DSS is used.
methodsData were used from the Second Dutch National Survey of General Practice (DNSGP2), collected in 2001. A total of 82 diagnoses, 749811 contacts, 133 physicians, and 85 practices was included in the analyses. GPs using the DSS daily were compared to GPs who do not use the DSS. Multilevel analyses were used to analyse the data. Two outcome measures were chosen: whether prescription was in accordance with the advice of the DSS or not, and a measure of concentration, the Herfindahl-Hirschman Index (HHI).
resultsGPs who use the DSS daily prescribe more according to the advice given in the DSS than GPs who do not use the DSS. Contradictory to our expectation there was no significant difference between the HHIs for both groups: variation in prescription was comparable.
conclusionWe studied the use of a DSS for drug prescribing in general practice in the Netherlands. The DSS is based on guidelines developed by the Dutch College of General Practitioners and implemented in the Electronic Medical Systems of the GPs. GPs using the DSS more often prescribe in accordance with the advice given in the DSS compared to GPs not using the DSS. This finding, however, did not mean that variation is lower; variation is the same for GPs using and for GPs not using a DSS. Implications of the study are that DSSs can be used to implement guidelines, but that it should not be expected that variation is limited.
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