[Drug therapy in a nursing home; favorable effect of feedback by the pharmacist on family physician's prescribing behavior]

Abstract

Objective: Investigating whether and how the prescribing behaviour of general practitioners (GPs) can be changed by the pharmacist's feedback.

Design: Randomised, prospective.

Setting: Residential home 'Bernlef', Groningen, the Netherlands.

Method: In the period 2 February-18 March 1993 the effect of different ways of sending prescriptions by the pharmacist on medication use was investigated. The 43 GPs of the inhabitants were randomly divided in 3 groups. Group A formed the control group and was requested to send their prescriptions as before, group B moreover received a list with the medication used by their patients, group C also got a list with the actual medication of their patients as well as recommendations by the pharmacist. Effects on medication use were determined after 4 weeks.

Results: The 196 inhabitants used an average of 6.5 drugs (range 0-19). No difference was found between group A and group B, but there was a difference with group C. In all three groups the number of added drugs increased by 5%, but the number of deleted drugs was 7% in group C, as against only 3% in groups A and B (p < 0.05). The feedback of the pharmacist that for 44% of GPs contained new information resulted 9 times in the ending of medication and 4 times in decreasing of the dose.

Conclusion: Pharmacist's feedback by means of remarks on prescribed medication positively influences prescription behaviour of the GP.