Article Figures & Data
Tables
Baseline Characteristics Intervention Group(n = 19) No. Control Group(n = 19) No. GERD = gastroesophageal reflux disease, COX-2 inhibitors = selective cyclooxygenase 2 inhibitors, NSAIDs = nonsteroidal anti-inflammatory drugs. P >.1 for all baseline comparisons, except GERD medications (P = .04). Member months 91,542 92,094 Number of patients treated with a new prescription 3,305 3,307 Number of new prescriptions 5,920 5,920 Number of new and refilled prescriptions 13,347 13,533 Number of patients with a new prescription from the high-cost drug categories No. (%) No. (%) Antibiotics 923 (28) 954 (29) Antidepressants 369 (11) 367 (11) Rhinitis medications 334 (10) 346 (11) GERD medications 253 (8) 189 (6) Asthma medications 262 (8) 218 (7) Diabetes medications 154 (5) 177 (5) Antihypertension medications, diuretics 393 (12) 411 (12) Lipid-lowering therapies 150 (5) 204 (6) Triptans and headache medications 91 (3) 79 (2) COX-2 inhibitors and NSAIDs 385 (12) 277 (8) Total 2,496 (76) 2,434 (74) Prescription Category Baseline Mean $ (SE) Study Period Mean $ (SE) Change From Baseline P * Value Note: values are least squares mean (SE). P >.1 for all baseline comparisons. * P value for mixed model analysis (group-time interaction). † P <.05 for comparison of baseline vs study period. New prescriptions Intervention group 38.53 (1.63) 37.28 (1.62) −1.25 .02 Control group 38.47 (1.60) 41.38 (1.61) 2.91† New and refilled prescriptions Intervention group 43.71 (1.60) 40.56 (1.59) −3.15† .01 Control group 44.06 (1.59) 45.90 (1.59) 1.84 Prescription Category Baseline Mean $ (SE) Study Period Mean $ (SE) Change From Baseline P * Value Note: values are least squares mean (SE). P >.1 for all baseline comparisons except rhinitis medications (P = .03) and triptan and headache medications (P = .07). GERD = gastroesophageal reflux disease, COX-2 inhibitors = selective cyclooxygenase 2 inhibitors, NSAIDs = nonsteroidal anti-inflammatory drugs. * P value for mixed model analysis (group-time interaction). † P <.05 for difference between groups during the study period. ‡ P <.05 for comparison of baseline vs study period. Antibiotics Intervention group 27.19 (2.27) 25.04 (2.29) −2.15 .69 Control group 29.92 (2.18) 28.88 (2.26) −1.04 Antidepressants Intervention group 60.37 (2.87) 50.59 (2.83) −9.78†‡ .06 Control group 62.05 (2.85) 60.22 (2.93) −1.83 Rhinitis medications Intervention group 69.11 (2.21) 66.58 (2.07) −2.53 .24 Control group 62.27 (2.85) 64.48 (2.10) 2.21 GERD medications Intervention group 96.08 (6.21) 84.38 (6.04) −11.70† .10 Control group 104.73 (6.25) 108.83 (5.93) 4.10 Asthma medications Intervention group 62.65 (4.54) 49.92 (4.55) −12.73‡ .25 Control group 64.84 (4.47) 61.73 (4.58) −3.11 Diabetes medications Intervention group 53.15 (4.74) 42.09 (5.14) −11.06 .94 Control group 59.95 (4.55) 48.22 (4.83) −11.73 Antihypertension medications, diuretics Intervention group 23.52 (1.19) 18.36 (1.16) −5.16†‡ .30 Control group 25.83 (1.18) 22.65 (1.15) −3.18‡ Lipid-lowering agents Intervention group 73.06 (4.07) 66.55 (3.95) −6.51 .49 Control group 74.85 (3.76) 62.98 (3.85) −11.87‡ Triptans and headache medications Intervention group 94.81 (9.60) 67.02 (9.22) −27.79‡ .01 Control group 69.26 (9.69) 88.95 (9.64) 19.69 COX-2 inhibitors and NSAIDs Intervention group 25.51 (4.69) 29.53 (4.64) 4.02 .59 Control group 33.00 (4.63) 40.53 (4.54) 7.53 Totals for high-cost drug categories Intervention group 49.94 (2.05) 45.03 (2.03) −4.91†‡ .06 Control group 52.12 (2.03) 51.63 (2.02) −0.49
Additional Files
Supplemental Figures
Figure 1: Prewritten prescriptions most appropriate for gastroesophageal reflux, with a brief, diagnosis-specific message; Figure 2: Example message-of-the-day screen.
Files in this Data Supplement:
- Supplemental data: Figure 1 - PDF file, 1 page, 47 KB
- Supplemental data: Figure 2 - PDF file, 1 page, 45 KB
The Article in Brief
Doctors often learn about a new drug from information provided by the pharmaceutical company that makes the drug. Computer systems have been developed to help doctors select prescriptions based on scientific evidence. These systems also provide the doctor with information about the effectiveness, safety, and costs of drugs; new research findings; and prewritten prescriptions. Spending on drugs dropped among doctors using such a system, while spending on drugs increased among doctors not using the system. *Conflicts of interest: Authors McMullin and Longergan are salaried employees of WELLINX (St. Louis, Mo), owner of the computerized decision support system used by the intervention group. Co-author Dr. Thomas D. Doerr, MD, is one of the founders of WELLINX and has an ownership interest in the company.
