Cough and cold medicine prescription rates can be significantly reduced by active intervention.
Cough and cold medicine prescription rates can be significantly reduced by active intervention.
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DOI：
10.1007/s00431-021-04344-0
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发表时间：
2022-04
影响因子：
3.6
通讯作者：
Korppi M
中科院分区：
文献类型：
--
作者：
Csonka P;Heikkilä P;Koskela S;Palmu S;Lajunen N;Riihijärvi S;Huhtala H;Korppi M
我们的目的是建立和测试一个干预方案，以消除咳嗽和感冒药（CCM）处方的儿童在全国性的医疗服务公司治疗。这项研究是在芬兰最大的私人医疗服务公司进行的，该公司拥有一个集中的电子健康记录系统，可以实时监控医生的具体实践。逐步干预包括在公司层面向医生和家庭分发教育材料、教育工作人员会议、持续监测处方和有针对性的反馈。对不遵守规定的单位进行了外联访问。最后，直接联系那些最常开CCM处方的医生。在干预期间（2017-2020年），有超过100万人次的儿科就诊。41%的单位完全消除了CCM儿童处方，CCM处方总数从6738个减少到744个（89%）。在第四个干预年，仅为0.2%的2岁以下儿童开具了含有阿片类衍生物的CCM。全科医生的处方减少最多（5.2%至1.1%）。儿科医生的处方率从1.5%下降到0.2%。CCM的年度成本从183，996欧元降至18，899欧元（89.7%）。在4年的干预中，开发人员使用了343小时，参加的医生使用了684小时的工作时间。用于开发、实施、报告、评估、沟通和数据管理的成本约占干预总成本的11%。结论：该研究表明，在全国范围内进行系统干预以改变咳嗽药处方做法是可行的，只需要少量的财政投资。在线版本包含补充材料，可通过10.1007/s 00431 -021-04344-0获得。
Our aim was to construct and test an intervention programme to eradicate cough and cold medicine (CCM) prescriptions for children treated in a nationwide healthcare service company. The study was carried out in the largest private healthcare service company in Finland with a centralised electronic health record system allowing for real-time, doctor-specific practice monitoring. The step-by-step intervention consisted of company-level dissemination of educational materials to doctors and families, educational staff meetings, continuous monitoring of prescriptions, and targeted feedback. Outreach visits were held in noncompliant units. Finally, those physicians who most often prescribed CCM were directly contacted. During the intervention period (2017–2020), there were more than one million paediatric visits. Prescriptions of CCMs to children were completely eradicated in 41% of units and the total number of CCM prescriptions decreased from 6738 to 744 (89%). During the fourth intervention year, CCMs containing opioid derivatives were prescribed for only 0.2% of children aged < 2 years. The decrease in prescriptions was greatest in general practitioners (5.2 to 1.1%). In paediatricians, the prescription rates decreased from 1.5 to 0.2%. The annual costs of CCMs decreased from €183,996 to €18,899 (89.7%). For the intervention, the developers used 343 h and the attended doctors used 684 h of work time during the 4-year intervention. The costs used for developing, implementing, reporting, evaluating, communicating, and data managing formed approximately 11% of total intervention costs. Conclusion: The study showed that a nationwide systematic intervention to change cough medicine prescription practices is feasible and requires only modest financial investments. The online version contains supplementary material available at 10.1007/s00431-021-04344-0.
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影响因子：
8
作者：
Hampton LM;Nguyen DB;Edwards JR;Budnitz DS
通讯作者：
Budnitz DS
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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作者：
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通讯作者：
TARGET team