Journal of General Internal Medicine

, Volume 17, Issue 10, pp 792–796

Modifying provider behavior

A low-tech approach to pharmaceutical ordering
  • Jeffrey J. Guterman
  • Bruce A. Chernof
  • Beatriz Mares
  • Sandra G. Gross-Schulman
  • Pramod G. Gan
  • Donald ThomasIII
Brief Reports

DOI: 10.1046/j.1525-1497.2002.20144.x

Cite this article as:
Guterman, J.J., Chernof, B.A., Mares, B. et al. J GEN INTERN MED (2002) 17: 792. doi:10.1046/j.1525-1497.2002.20144.x

Abstract

OBJECTIVE: To determine if a clinically structured, paperbased prescription form can modify pharmaceutical prescribing behavior without restricting physician freedom to select the most appropriate medication for an individual patient.

DESIGN: Uncontrolled, nonrandomized, time series design.

SETTING: The urgent care clinic of a university-affiliated, county-supported hospital that provides care for underserved, vulnerable populations.

PATIENTS: Patients (N=2,189) who had a prescription written at the intervention site during the study.

INTERVENTION: Four-phase interventions lasting 2 weeks each, with a washout period between each phase, consisting of: (1) collection of baseline data utilizing the traditional prescription blank, (2) introduction of the pre-formatted prescription form, (3) use of the pre-formatted prescription form with medication cost added, and (4) pre-formatted prescription form with target drug (ranitidine) removed.

MEASUREMENTS AND MAIN RESULTS: Physicians were less likely to prescribe ranitidine compared to cimetidine after the introduction of the cost information (P<.01) and again after the removal of ranitidine from the pre-formatted prescription form (P<.001).

CONCLUSIONS: A structured, paper-based prescription order form can shift prescribing practices without inhibiting physicians’ ordering freedom.

Key words

structured prescription forms provider behavior modification pharmaceutical cost 

Copyright information

© Society of General Internal Medicine 2002

Authors and Affiliations

  • Jeffrey J. Guterman
    • 1
    • 2
    • 3
    • 6
  • Bruce A. Chernof
    • 1
    • 3
    • 4
  • Beatriz Mares
    • 5
  • Sandra G. Gross-Schulman
    • 6
  • Pramod G. Gan
    • 1
    • 3
    • 6
  • Donald ThomasIII
    • 6
  1. 1.Received from the Department of MedicineUniversity of California-Los AngelesLos Angeles
  2. 2.the Department of Emergency MedicineUniversity of California-Los AngelesLos Angeles
  3. 3.the Department of Ambulatory and Community MedicineOlive View-UCLA Medical CenterSylmar
  4. 4.Foundation Health PlanWoodland Hills
  5. 5.University of California-Los Angeles School of MedicineLos Angeles
  6. 6.Los Angeles County Department of Health ServicesLos Angeles
  7. 7.Olive View-UCLA Medical CenterSylmar

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