PICME - 3 methods compared for improving prescribing in Spain

Interesting study from Spain of 3 different interventions, compared to control, to improve prescribing safety in primary care. [1]

• control
• report (received feedback reports)
• session (group sessions)
• face-to-face (personal interviews)

No improvement was seen in the report group compared to the control. Face to face was more expensive. The best seemed to be the session group which was the most cost-effective at reducing drug interactions.

An older study on prescribing quality in Spain showed that one-to-one was better than group learning. [2]

It is likely that local context and the exact mode of delivery of interventions explains a lot of the variation in outcomes. What is hard in this type of research is to learn what can be generalised to other circumstances.

1.

Lopez-Picazo JJ, Ruiz JC, Sanchez JF, Ariza A, Aguilera B. A randomized trial of the effectiveness and efficiency of interventions to reduce potential drug interactions in primary care. Am J Med Qual 2011 Apr;26(2):145-153.[cited 2011 Jul 25] Available from: http://www.ncbi.nlm.nih.gov/pubmed/21403177

2.

Figueiras A, Sastre I, Tato F, Rodríguez C, Lado E, Caamaño F, Gestal-Otero JJ. One-to-one versus group sessions to improve prescription in primary care: a pragmatic randomized controlled trial. Med Care 2001 Feb;39(2):158-167. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11176553