Research article

Effectiveness and costs of implementation strategies to reduce acid suppressive drug prescriptions: a systematic review

Hugo M Smeets^1,2 , Arno W Hoes¹ and Niek J de Wit¹

¹Julius Centrum for Health Sciences and Primary Care, UMC Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands

²Agis, Van Asch van Wijckstraat 55, 3811 LP, Amersfoort, The Netherlands

author email corresponding author email

BMC Health Services Research 2007, 7:177doi:10.1186/1472-6963-7-177

Published:	5 November 2007

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.