[Efficacy of educational sessions to modify the prescription of new drugs]. / Eficacia de las sesiones educativas para modificar la prescripción de fármacos nuevos.

OBJECTIVE: To evaluate the efficacy of an educational intervention to minimise the prescription of those new medicines whose therapeutic effects are of little benefit. DESIGN: Controlled and randomised experimental study. SETTING: 27 health centres in the province of Sevilla, Spain. PARTICIPANTS: 376 general practitioners. The 264 who worked in the same posts were randomised for the 6 pre-intervention months. 10 of them did not complete the post-intervention period. INTERVENTIONS: Four 45-minute training sessions in a 2-month period, given by health team doctors, with a critical reading of the studies available on recently marketed drugs, plus personal feed-back on prescription and bulletins on therapeutic novelties. The control group received only the feed-back and bulletins. MAIN MEASUREMENTS: Prescription of new medication of little benefit, measured as the number of packages out of the total. Second, the amount of coxib and eprosartan measured as defined daily doses. RESULTS: In the 6 months after the educational sessions, the doctors in the intervention group prescribed proportionately fewer therapeutic novelties of little benefit than those allocated to the control group (1.34% vs 1.62%; P<.001). The coxib and eprosartan prescribed showed only a non-significant trend towards less prescription by the intervention group. CONCLUSIONS: The group educational sessions, run by doctors trained in aspects of evidence-based medicine and prepared jointly with the pharmacy unit, reduced discreetly the prescription of new medicines that were not very innovative.

Eficacia de las sesiones educativas para modificar la prescripción de fármacos nuevos / Efficacy of educational sessions to modify the prescription of new drugs

Objetivo. Evaluar la eficacia de una intervención educativa para minimizar la prescripción de medicamentos nuevos cuya aportación terapéutica es poco relevante. Diseño. Estudio experimental, controlado y aleatorizado. Emplazamiento. El estudio se realizó en 27 centros de salud de la provincia de Sevilla. Participantes. Participaron 376 médicos de familia generalistas. Se aleatorizó a los 264 que trabajaron en una misma plaza los 6 meses preintervención; 10 de ellos no completaron el período postintervención. Intervenciones. Se realizaron 4 sesiones formativas de 45 minutos en un intervalo de 2 meses, impartidas por médicos de equipos de salud, sobre lectura crítica de los estudios disponibles de medicamentos de reciente comercialización, además de retroinformación personalizada de la prescripción y los boletines sobre novedades terapéuticas. El grupo control recibió sólo la retroinformación y los boletines. Mediciones principales. Prescripción de medicamentos nuevos poco relevantes, medida como la proporción de envases respecto al total de medicamentos. Secundariamente, se midió la proporción de coxib y eprosartán medida como dosis diarias definidas. Resultados. En los 6 meses posteriores a las sesiones educativas, los médicos del grupo intervención prescribieron proporcionalmente menos novedades terapéuticas no relevantes que los asignados al grupo control (el 1,34 frente al 1,62%, respectivamente; p < 0,001). La proporción de coxib y eprosartán sólo muestra una tendencia no significativa hacia una menor prescripción por el grupo intervención. Conclusiones. Las sesiones educativas grupales, mediadas por médicos formados en elementos de medicina basada en la evidencia y preparadas de manera conjunta con la unidad de farmacia, disminuyen de manera discreta la prescripción de medicamentos nuevos escasamente innovadores

Objective. To evaluate the efficacy of an educational intervention to minimise the prescription of those new medicines whose therapeutic effects are of little benefit. Design. Controlled and randomised experimental study. Setting. 27 health centres in the province of Sevilla, Spain. Participants. 376 general practitioners. The 264 who worked in the same posts were randomised for the 6 pre-intervention months. 10 of them did not complete the post-intervention period. Interventions. Four 45-minute training sessions in a 2-month period, given by health team doctors, with a critical reading of the studies available on recently marketed drugs, plus personal feed-back on prescription and bulletins on therapeutic novelties. The control group received only the feed-back and bulletins. Main measurements. Prescription of new medication of little benefit, measured as the number of packages out of the total. Second, the amount of coxib and eprosartan measured as defined daily doses. Results. In the 6 months after the educational sessions, the doctors in the intervention group prescribed proportionately fewer therapeutic novelties of little benefit than those allocated to the control group (1.34% vs 1.62%; P<.001). The coxib and eprosartan prescribed showed only a non-significant trend towards less prescription by the intervention group. Conclusions. The group educational sessions, run by doctors trained in aspects of evidence-based medicine and prepared jointly with the pharmacy unit, reduced discreetly the prescription of new medicines that were not very innovative