Design and results of a group counter-detailing DUR educational program

Abstract

Purpose: The study objectives were to (1) design, (2) implement and (3) evaluate a multi-step educational program as an integral component of a healthcare system's activities to improve medication use quality and control drug costs. Design and implementation of the educational program were based upon established principles of changing prescriber behavior. Two classes of oral medications, antihistamines and antibiotics, were targeted.

Methods: A before-after nonequivalent comparison group design with 2 comparison groups was used for evaluation. Medication claims data from the same time period one year previously were used as historical controls. Prescribing rates, net savings and prescribers' attitudes were assessed.

Results: Prescribing trends in the treatment group but not comparison groups generally reflected changes consistent with the educational message. A net savings of $84 was achieved in the antihistamine program. A net loss of ($2722) was seen in the antibiotic program. Over 75 percent of prescribers agreed or strongly agreed that the educational program was an appropriate mechanism to optimize medication use. Level of exposure and practice years affected perceived knowledge gains.

Conclusion: The group counter-detailing DUR educational program was effective in improving prescribing rates. Prescribing rate changes and economic impacts differed by therapeutic category. The entire program was well accepted among prescribers including physicians and nurse practitioners.