Design and evaluation of a computer reminder system to improve prescribing behaviour of GPs.

Objective: To evaluate the implementation of a decision support system with reactive computer reminders to improve drug prescribing behaviour.

Methods: A clustered RCT with an incomplete block design was carried out in the south of the Netherlands: 25 GPs received reminders on antibiotics and asthma/COPD prescriptions, 28 GPs received reminders on cholesterol prescriptions. Prescribing guidelines were integrated into the GP information system, which was installed in the GPs practices of the intervention group. When the computer program was in use, a reminder popped up if the GP deviated from the guidelines during prescribing.

Primary Outcome: prescription according to the guidelines as a percentage of total prescriptions of a specific drug. Furthermore, an evaluation on the user-friendliness of the CRS in the GP's practice was carried out through questionnaires and interviews.

Results: Presently analyses are being carried out. Preliminary results indicate that the CRS study supported our expectations. In general, there seems to be a reduction in the numbers of prescriptions according to the advices of the computerised guidelines not to prescribe certain drugs. Final analysis will be performed shortly. In general, the Computer Reminder System was perceived as stable and user friendly.

Conclusion: We created a stable and user friendly Computer Reminder System which was adjusted to the needs and demands of GPs. Preliminary results regarding the effectiveness of the system seem to indicate that the implementation of a Computer Reminder System with reactive reminders improves drug prescribing behaviour.