Increasing generic prescribing: a resident educational intervention.
OBJECTIVE
Future physicians are urged to balance effectiveness and cost in their prescribing of medications. This study determined whether educational sessions for residents together with a "Resident Report Card" changed residents' prescribing of generic medications in both commercial and Medicaid patient panels, compared with regional performance of physicians in practice in the community.


METHODS
Twenty-four family medicine residents providing care for 1,038 (600 Medicaid and 438 commercial) members (or 31,140 total member months) received biannual profiles of their prescribing patterns and participated in four training sessions related to prescription profiling within a regional health plan. We monitored prescribing during two time periods and compared rates of generic prescribing to a baseline rate.


RESULTS
Resident generic prescribing increased significantly for commercial members, from a base period (July 1, 2000-June 30, 2001) rate of 38.4% to a period 1 (July 1, 2001-June 30, 2002) rate of 38.0% and a period 2 (July 1, 2002-December 31, 2002) rate of 47.9%. It also increased for Medicaid members, from a base period rate of 47.8% to a period 1 rate of 49.1% and a period 2 rate of 52.6%. There was no similar change in regional prescribing performance during the same periods for physicians in practice in the community.


CONCLUSIONS
Feedback systems and training based on actual health plan data can be developed for residency training on prescribing performance, resulting in improved cost-efficient prescribing patterns.
Wadland
William C
WC
Department of Family Practice, Michigan State University, MI 48824-1313, USA. wadland@msu.edu
Farquhar
Lynda
L
Priester
Faith
F
Oberst
Kathleen
K
Weismantel
David P
DP
D016527:Drug Costs; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D016568:Drugs, Generic; D005194:Family Practice / Q000191:economics / Q000193:education*; D007396:Internship and Residency; D008329:Managed Care Programs; D008484:Medicaid; D010818:Practice Patterns, Physicians'
D016568:Drugs, Generic