Aims

To explore the impact of a prescribing feedback intervention on insulin prescribing.

Methods

This was a mixed-methods study in a hospital setting. An insulin prescribing feedback intervention was delivered verbally and in writing to twelve doctors. Insulin prescribing error frequency was compared to ten doctors who had not received the feedback intervention. Insulin prescribing was audited over four weeks at the start and end of the intervention period. Semi-structured interviews were conducted with participating doctors who had received feedback, and qualitative data analysed thematically to explore the impact of the intervention on their prescribing practice.

Results

Prescribing data were collected on 370 insulin prescriptions with 241 errors identified. A significant reduction (χ2 = 22.6, p=<0.05) in insulin prescribing error frequency was observed in the intervention group, with a non-significant increase reported in the control group. Feedback was received positively and considered valuable by doctors, supporting development of their knowledge and skills and encouraging reflection on their prescribing performance. Doctors described enhanced confidence in insulin prescribing and a desire to improve as a prescriber and avoid harm, with feedback raising awareness of their development needs. Prescribers also described enhanced team work, with greater information and feedback seeking behavior to inform future prescribing decisions.

Conclusions

Feedback has potential to improve insulin prescribing and is a valued and acceptable process intervention for doctors. The impact on insulin prescribing practice is varied and complex influencing the capability, opportunity and motivation of prescribers to adapt and evolve their behavior in response to ongoing feedback.

中文翻译：

---

药师主导的反馈试点干预对医院胰岛素处方影响的混合方法评估

宗旨

探讨处方反馈干预对胰岛素处方的影响。

方法

这是一项在医院环境中进行的混合方法研究。以口头和书面形式向 12 位医生提供了胰岛素处方反馈干预。将胰岛素处方错误频率与十位未接受反馈干预的医生进行比较。在干预期开始和结束时对胰岛素处方进行了 4 周的审核。与收到反馈的参与医生进行了半结构化访谈，并对定性数据进行了专题分析，以探讨干预对其处方实践的影响。

结果

收集了 370 份胰岛素处方的处方数据，确定了 241 个错误。在干预组中观察到胰岛素处方错误频率显着降低（χ2 = 22.6，p=<0.05），而对照组报告的增加不显着。医生收到了积极的反馈并认为他们很有价值，这支持了他们知识和技能的发展，并鼓励了他们对处方表现的反思。医生们描述了对胰岛素处方的信心增强以及作为处方者改进和避免伤害的愿望，并通过反馈提高了对其发展需求的认识。处方者还描述了增强的团队合作，更多的信息和反馈寻求行为为未来的处方决定提供信息。

结论

反馈具有改善胰岛素处方的潜力，并且对于医生来说是一种有价值且可接受的过程干预。对胰岛素处方实践的影响多种多样且复杂，影响着处方者根据持续反馈调整和发展其行为的能力、机会和动机。