Effectiveness and Costs of Implementation Strategies to Reduce Acid Suppressive Drug Prescriptions: a Systematic Review

Overview

Journal BMC Health Serv Res

Publisher Biomed Central

Specialty Health Services

Date 2007 Nov 7

PMID 17983477

Citations 8

Authors

Hugo M Smeets

Arno W Hoes

Niek J de Wit

Affiliations

Soon will be listed here.

Abstract

Background: Evaluation of evidence for the effectiveness of implementation strategies aimed at reducing prescriptions for the use of acid suppressive drugs (ASD).

Methods: A systematic review of intervention studies with a design according to research quality criteria and outcomes related to the effect of reduction of ASD medication retrieved from Medline, Embase and the Cochrane Library. Outcome measures were the strategy of intervention, quality of methodology and results of treatment to differences of ASD prescriptions and costs.

Results: The intervention varied from a single passive method to multiple active interactions with GPs. Reports of study quality had shortcomings on subjects of data-analysis. Not all outcomes were calculated but if so rction of prescriptions varied from 8% up to 40% and the cost effectiveness was in some cases negative and in others positive. Few studies demonstrated good effects from the interventions to reduce ASD.

Conclusion: Poor quality of some studies is limiting the evidence for effective interventions. Also it is difficult to compare cost-effectiveness between studies. However, RCT studies demonstrate that active interventions are required to reduce ASD volume. Larger multi-intervention studies are necessary to evaluate the most successful intervention instruments.

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References

Talley N, Lauritsen K, Tunturi-Hihnala H, Lind T, Moum B, Bang C . Esomeprazole 20 mg maintains symptom control in endoscopy-negative gastro-oesophageal reflux disease: a controlled trial of 'on-demand' therapy for 6 months. Aliment Pharmacol Ther. 2001; 15(3):347-54. DOI: 10.1046/j.1365-2036.2001.00943.x. View

OBrien M, Rogers S, Jamtvedt G, Oxman A, Odgaard-Jensen J, Kristoffersen D . Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2007; (4):CD000409. PMC: 7032679. DOI: 10.1002/14651858.CD000409.pub2. View

de Wit N, Mendive J, Seifert B, Cardin F, Rubin G . Guidelines on the management of H.pylori in primary care: development of an implementation strategy. Fam Pract. 2000; 17 Suppl 2:S27-32. DOI: 10.1093/fampra/17.suppl_2.s27. View

Allison J, Hurley L, Hiatt R, Levin T, Ackerson L, Lieu T . A randomized controlled trial of test-and-treat strategy for Helicobacter pylori: clinical outcomes and health care costs in a managed care population receiving long-term acid suppression therapy for physician-diagnosed peptic ulcer disease. Arch Intern Med. 2003; 163(10):1165-71. DOI: 10.1001/archinte.163.10.1165. View

Sanchez-del Rio A, Quintero E, Alarcon O . [Appropriateness of indications for upper gastrointestinal endoscopy in open-access endoscopy units]. Gastroenterol Hepatol. 2004; 27(3):119-24. DOI: 10.1157/13058395. View

Quartero A, Post M, Numans M, de Melker R, de Wit N . What makes the dyspeptic patient feel ill? A cross sectional survey of functional health status, Helicobacter pylori infection, and psychological distress in dyspeptic patients in general practice. Gut. 1999; 45(1):15-9. PMC: 1727566. DOI: 10.1136/gut.45.1.15. View

Krol N, Wensing M, Haaijer-Ruskamp F, Muris J, Numans M, Schattenberg G . Patient-directed strategy to reduce prescribing for patients with dyspepsia in general practice: a randomized trial. Aliment Pharmacol Ther. 2004; 19(8):917-22. DOI: 10.1111/j.1365-2036.2004.01928.x. View

Jones R, Lydeard S, Dunleavey J . Problems with implementing guidelines: a randomised controlled trial of consensus management of dyspepsia. Qual Health Care. 1993; 2(4):217-21. PMC: 1055149. DOI: 10.1136/qshc.2.4.217. View

Talley N, Vakil N, Delaney B, Marshall B, Bytzer P, Engstrand L . Management issues in dyspepsia: current consensus and controversies. Scand J Gastroenterol. 2004; 39(10):913-8. DOI: 10.1080/00365520410003452. View

10.

Soo S, Moayyedi P, Deeks J, Delaney B, Innes M, Forman D . Pharmacological interventions for non-ulcer dyspepsia. Cochrane Database Syst Rev. 2000; (2):CD001960. DOI: 10.1002/14651858.CD001960. View

11.

Kearney D, Liu C, Crump C, Brousal A . The effect of a Helicobacter pylori treatment strategy on health care expenditures in patients with peptic ulcer disease and dyspepsia. Am J Gastroenterol. 2003; 98(9):1952-62. DOI: 10.1111/j.1572-0241.2003.07584.x. View

12.

Talley N . Drug treatment of functional dyspepsia. Scand J Gastroenterol Suppl. 1991; 182:47-60. View

13.

Grol R, Dalhuijsen J, Thomas S, Veld C, Rutten G, Mokkink H . Attributes of clinical guidelines that influence use of guidelines in general practice: observational study. BMJ. 1998; 317(7162):858-61. PMC: 31096. DOI: 10.1136/bmj.317.7162.858. View

14.

Hurenkamp G, Grundmeyer H, Bindels P, Tytgat G, van der Hulst R . How do primary care physicians use long-term acid suppressant drugs? A population-based analysis of Dutch general practices. J Fam Pract. 2002; 51(3):241-5. View

15.

Veldhuyzen van Zanten S, Flook N, Chiba N, Armstrong D, Barkun A, Bradette M . An evidence-based approach to the management of uninvestigated dyspepsia in the era of Helicobacter pylori. Canadian Dyspepsia Working Group. CMAJ. 2000; 162(12 Suppl):S3-23. PMC: 1232536. View

16.

Delaney B . Review article: prevalence and epidemiology of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2004; 20 Suppl 8:2-4. DOI: 10.1111/j.1365-2036.2004.02219.x. View

17.

Ladabaum U, Fendrick A, Scheiman J . Outcomes of initial noninvasive Helicobacter pylori testing in U.S. primary care patients with uninvestigated dyspepsia. Am J Gastroenterol. 2001; 96(7):2051-7. DOI: 10.1111/j.1572-0241.2001.03938.x. View

18.

PETERSON W, Fendrick A, Cave D, Peura D, Laine L . Helicobacter pylori-related disease: guidelines for testing and treatment. Arch Intern Med. 2000; 160(9):1285-91. DOI: 10.1001/archinte.160.9.1285. View

19.

Axon A, Bell G, Jones R, Quine M, McCloy R . Guidelines on appropriate indications for upper gastrointestinal endoscopy. Working Party of the Joint Committee of the Royal College of Physicians of London, Royal College of Surgeons of England, Royal College of Anaesthetists, Association of.... BMJ. 1995; 310(6983):853-6. PMC: 2549224. DOI: 10.1136/bmj.310.6983.853. View

20.

Cardin F, Zorzi M, Bovo E, Guerra C, Bandini F, Polito D . Effect of implementation of a dyspepsia and Helicobacter pylori eradication guideline in primary care. Digestion. 2005; 72(1):1-7. DOI: 10.1159/000087215. View