Abstract
BackgroundGeneral practitioners (GPs), or family practitioners, are tasked with prescribing medications that can be harmful to the community if they are inappropriately prescribed or used (e.g. opioids). Educational programs, such as educational outreach (EO), are designed to change the behaviour of health professionals. The purpose of this study was to identify the efficacy of EO programs at changing the prescribing behaviour of GPs.MethodsThis study included an evidence and practice review, comprising a rapid review supplemented by interviews with people who are familiar with EO implementation for regulation purposes. Seven databases were searched using terms related to health professionals and prescribing. Systematic and narrative reviews published in English after 2007 were included. Non-statistical analysis was used to report intervention efficacy. Three government representatives participated in semi-structured interviews to aid in understanding the relevance of review findings to the Victorian context. Interviews were transcribed verbatim and thematically analysed for emerging themes.ResultsFourteen reviews were identified for the evidence review. Isolated (e.g. EO program delivered by itself) and multifaceted (e.g. EO program supplemented by other interventions) programs were found to change prescribing behaviours. However, limited evidence suggests that EO can successfully change prescribing behaviours specific to GPs. Isolated EO can successfully change health professional prescribing behaviours, although cheaper alternatives such as letters might be just as effective. Multifaceted EO can also successfully change health professional prescribing behaviours, especially in older adults, but it remains unclear as to what combination of interventions works best. Success factors for EO reported by government representatives included programs having practical rather than didactic foci; making EO compulsory; focussing EO on preventing adverse events; using monetary or professional development incentives; and in-person delivery.ConclusionsEducational outreach can successfully change prescribing behaviours but evidence specific to GPs is lacking. Key characteristics of EO that could optimise success include ensuring the EO program is tailored, involves practical learning and uses incentives that are meaningful to clinicians.
Highlights
General practitioners (GPs), or family practitioners, are tasked with prescribing medications that can be harmful to the community if they are inappropriately prescribed or used
This review aims to report factors that are perceived to facilitate GP engagement in educational outreach (EO)
Results synthesis The following results section includes a synthesis of the findings from 13 systematic reviews and one narrative review, with emphasis placed on the efficacy of EO in isolation or as part of multifaceted programs aimed at changing health professional prescribing behaviour
Summary
General practitioners (GPs), or family practitioners, are tasked with prescribing medications that can be harmful to the community if they are inappropriately prescribed or used (e.g. opioids). Educational programs, such as educational outreach (EO), are designed to change the behaviour of health professionals. The purpose of this study was to identify the efficacy of EO programs at changing the prescribing behaviour of GPs. Prescription medications are a cornerstone of communitybased healthcare, especially in first world countries. Prescription medications are a cornerstone of communitybased healthcare, especially in first world countries They are used to successfully manage a broad range of health conditions that appear in general medical practices including bacterial infections, chronic conditions such as diabetes, mental health conditions and everyday needs such as contraception. In 2016, the typical picture of an Australian dying from a medication-induced death was a middle-aged male who was accidentally misusing prescription medications (e.g. benzodiazepines or oxycodone) together with several other medications (polypharmacy) [4]
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