| Title |
A multifaceted intervention to reduce guideline non-adherence among prescribing physicians in Dutch hospitals
|
|---|---|
| Published in |
International Journal of Clinical Pharmacy, November 2017
|
| DOI | 10.1007/s11096-017-0553-0 |
| Pubmed ID | |
| Authors |
Jacqueline M. Bos, Stephanie Natsch, Patricia M. L. A. van den Bemt, Johan L. W. Pot, J. Elsbeth Nagtegaal, Andre Wieringa, Gert Jan van der Wilt, Peter A. G. M. De Smet, Cornelis Kramers |
| Abstract |
Background Despite the potential of clinical practice guidelines to improve patient outcomes, adherence to guidelines by prescribers is inconsistent. Objective The aim of the study was to determine whether an approach of introducing an educational programme for prescribers in the hospital combined with audit and feedback by the hospital pharmacist reduces non-adherence of prescribing physicians to key pharmacotherapeutic guidelines. Setting This prospective intervention study with a before-after design evaluated patients at surgical, urological and orthopaedic wards. Method An educational program covering pain management, antithrombotics, fluid and electrolyte management, prescribing in case of renal insufficiency, application of radiographic contrast agents and surgical antibiotic prophylaxis was presented to prescribers on the participating wards. Hospital pharmacists performed medication safety consultations, combining medication review of patients who are at risk for drug related problems with visits to ward physicians. Main outcome measure The outcome measure was the proportion of the admissions of patients in which the physician did not adhere to one or more of the included guidelines. Difference was expressed in odds ratios (OR) with 95% confidence intervals (CI). Multivariable logistic regression analysis was performed. Results 1435 Admissions of 1378 patients during the usual care period and 1195 admissions of 1090 patients during the intervention period were included. Non-adherence was observed significantly less often during the intervention period [21.8% (193/886)] as compared to the usual care period [30.5% (332/1089)]. The adjusted OR was 0.61 (95% CI 0.49-0.76). Conclusion This study shows that education and support of the prescribing physician can reduce guideline non-adherence at surgical wards. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 76 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 76 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 16 | 21% |
| Student > Ph. D. Student | 8 | 11% |
| Researcher | 6 | 8% |
| Student > Bachelor | 6 | 8% |
| Other | 5 | 7% |
| Other | 14 | 18% |
| Unknown | 21 | 28% |
| Readers by discipline | Count | As % |
|---|---|---|
| Pharmacology, Toxicology and Pharmaceutical Science | 20 | 26% |
| Medicine and Dentistry | 12 | 16% |
| Nursing and Health Professions | 9 | 12% |
| Social Sciences | 3 | 4% |
| Business, Management and Accounting | 2 | 3% |
| Other | 6 | 8% |
| Unknown | 24 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 November 2017.
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#15,695,859
of 23,323,574 outputs
Outputs from International Journal of Clinical Pharmacy
#820
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Outputs of similar age
#207,163
of 329,925 outputs
Outputs of similar age from International Journal of Clinical Pharmacy
#14
of 19 outputs
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