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.
structured prescription forms provider behavior modification pharmaceutical cost