Evidence map›Paper›PMID 36633309›Full record

SynthesisFamily practice2023

Audit and feedback interventions involving pharmacists to influence prescribing behaviour in general practice: a systematic review and meta-analysis.

Mary Carter, Nouf Abutheraa, Noah Ivers, Jeremy Grimshaw, Sarah Chapman, Philip Rogers, Michelle Simeoni, Jesmin Antony, Margaret C Watson

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Family practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mary CarterDepartment of Life Sciences, University of Bath, Bath, United Kingdom.ORCID 0000-0002-1063-5814
Nouf AbutheraaSchool of Medicine, University of Aberdeen, Aberdeen, United Kingdom.ORCID 0000-0003-2665-5630
Noah IversWomen's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.ORCID 0000-0003-2500-2435
Jeremy GrimshawCentre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.ORCID 0000-0001-8015-8243
Sarah ChapmanDepartment of Life Sciences, University of Bath, Bath, United Kingdom.ORCID 0000-0002-7612-1605
Philip RogersDepartment of Life Sciences, University of Bath, Bath, United Kingdom.ORCID 0000-0001-7574-7414
Michelle SimeoniPublic Health Ontario, Toronto, Ontario, Canada.ORCID 0000-0001-9396-2353
Jesmin AntonyWomen's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.ORCID 0000-0002-4101-8616
Margaret C WatsonStrathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom.ORCID 0000-0002-8198-9273

Funding

University of Bath
6 · The paper itself

Abstract

introductionPharmacists, as experts in medicines, are increasingly employed in general practices and undertake a range of responsibilities. Audit and feedback (A&F) interventions are effective in achieving behaviour change, including prescribing. The extent of pharmacist involvement in A&F interventions to influence prescribing is unknown. This review aimed to assess the effectiveness of A&F interventions involving pharmacists on prescribing in general practice compared with no A&F/usual care and to describe features of A&F interventions and pharmacist characteristics.

methodsElectronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, (Social) Science Citation Indexes, ISI Web of Science) were searched (2012, 2019, 2020). Cochrane systematic review methods were applied to trial identification, selection, and risk of bias. Results were summarized descriptively and heterogeneity was assessed. A random-effects meta-analysis was conducted where studies were sufficiently homogenous in design and outcome.

resultsEleven cluster-randomized studies from 9 countries were included. Risk of bias across most domains was low. Interventions focussed on older patients, specific clinical area(s), or specific medications. Meta-analysis of 6 studies showed improved prescribing outcomes (pooled risk ratio: 0.78, 95% confidence interval: 0.64-0.94). Interventions including both verbal and written feedback or computerized decision support for prescribers were more effective. Pharmacists who received study-specific training, provided ongoing support to prescribers or reviewed prescribing for individual patients, contributed to more effective interventions.

conclusionsA&F interventions involving pharmacists can lead to small improvements in evidence-based prescribing in general practice settings. Future implementation of A&F within general practice should compare different ways of involving pharmacists to determine how to optimize effectiveness.PRISMA-compliant abstract included in Supplementary Material 1.

Indexed as

General PracticePharmacistsFamily PracticeFeedbackHumansevidencegeneral practicepharmacistprescribingprimary caresystematic review

Identifiers

PMID36633309
PMCPMC10745261

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.