Low-value chronic prescription of acid reducing medication among Dutch general practitioners: impact of a patient education intervention

Abstract Background Dyspepsia is a commonly encountered clinical condition in Dutch general practice, which is often treated through the prescription of acid-reducing medication (ARM). However, recent studies indicate that the majority of chronic ARM users lack an indication for their use and that their long-term use is associated with adverse outcomes. We developed a patient-focussed educational intervention aiming to reduce low-value (chronic) use of ARM. Methods We conducted a randomized controlled study, and evaluated its effect on the low-value chronic prescription of ARM using data from... Mehr ...

Verfasser: Müskens, Joris L. J. M.
van Dulmen, Simone A.
Hek, Karin
Westert, Gert P.
Kool, Rudolf B.
Dokumenttyp: Artikel
Erscheinungsdatum: 2024
Reihe/Periodikum: BMC Primary Care ; volume 25, issue 1 ; ISSN 2731-4553
Verlag/Hrsg.: Springer Science and Business Media LLC
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27466883
Datenquelle: BASE; Originalkatalog
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Link(s) : http://dx.doi.org/10.1186/s12875-024-02351-2

Abstract Background Dyspepsia is a commonly encountered clinical condition in Dutch general practice, which is often treated through the prescription of acid-reducing medication (ARM). However, recent studies indicate that the majority of chronic ARM users lack an indication for their use and that their long-term use is associated with adverse outcomes. We developed a patient-focussed educational intervention aiming to reduce low-value (chronic) use of ARM. Methods We conducted a randomized controlled study, and evaluated its effect on the low-value chronic prescription of ARM using data from a subset ( n = 26) of practices from the Nivel Primary Care Database. The intervention involved distributing an educational waiting room posters and flyers informing both patients and general practitioners (GPs) regarding the appropriate indications for prescription of an ARM for dyspepsia, which also referred to an online decision aid. The interventions’ effect was evaluated through calculation of the odds ratio of a patient receiving a low-value chronic ARM prescription over the second half of 2021 and 2022 (i.e. pre-intervention vs. post-intervention). Results In both the control and intervention groups, the proportion of patients receiving chronic low-value ARM prescriptions slightly increased. In the control group, it decreased from 50.3% in 2021 to 49.7% in 2022, and in the intervention group it increased from 51.3% in 2021 to 53.1% in 2022. Subsequent statistical analysis revealed no significant difference in low-value chronic prescriptions between the control and intervention groups (Odds ratio: 1.11 [0.84–1.47], p > 0.05). Conclusion Our educational intervention did not result in a change in the low-value chronic prescription of ARM; approximately half of the patients of the intervention and control still received low-value chronic ARM prescriptions. The absence of effect might be explained by selection bias of participating practices, awareness on the topic of chronic AMR prescriptions and the relative low ...