Modifying provider behavior: a low-tech approach to pharmaceutical ordering.

Objective: To determine if a clinically structured, paper-based 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 = 2189) 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.