Modifying provider behavior: a low-tech approach to pharmaceutical ordering.
OBJECTIVE
To determine if a clinically structured, paper-based prescription form can modify pharmaceutical prescribing behavior without restricting physician freedom to select the most appropriate medication for an individual patient.


METHODS
Uncontrolled, nonrandomized, time series design.


METHODS
The urgent care clinic of a university-affiliated, county-supported hospital that provides care for underserved, vulnerable populations.


METHODS
Patients (N = 2189) who had a prescription written at the intervention site during the study.


METHODS
Four-phase interventions lasting 2 weeks each, with a washout period between each phase, consisting of: (1). collection of baseline data utilizing the traditional prescription blank, (2). introduction of the pre-formatted prescription form, (3). use of the pre-formatted prescription form with medication cost added, and (4). pre-formatted prescription form with target drug (ranitidine) removed.


RESULTS
Physicians were less likely to prescribe ranitidine compared to cimetidine after the introduction of the cost information (P <.01) and again after the removal of ranitidine from the pre-formatted prescription form (P <.001).


CONCLUSIONS
A structured, paper-based prescription order form can shift prescribing practices without inhibiting physicians' ordering freedom.
Guterman
Jeffrey J
JJ
Departments of Medicine and Emergency Medicine (JJG), University of California-Los Angeles, Los Angeles, Calif, USA. jguteman@pol.net
Chernof
Bruce A
BA
Mares
Beatriz
B
Gross-Schulman
Sandra G
SG
Gan
Pramod G
PG
Thomas
Donald
D
D001291:Attitude of Health Personnel; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D004364:Pharmaceutical Preparations; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'
D004364:Pharmaceutical Preparations