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Changing Physician Prescribing Practices: Title and subTitle BreakRegulation vs Education FREE

Robert L. Kane, MD; Judith Garrard, PhD
[+] Author Affiliations

Reprint requests to the University of Minnesota School of Public Health, Mayo Box 197, 420 Delaware St SE, Minneapolis, MN 55455 (Dr Kane).


JAMA. 1994;271(5):393-394. doi:10.1001/jama.1994.03510290075042
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Changing physicians' behavior is not easy.1 Although we would like to believe in a world where health professionals incorporate well-analyzed valid information into their daily practices, in fact, putting scientifically vetted information to use is slow and arduous. Translating consensus conference results into practice has proven a greater challenge than reaching consensus.2,3 The guidelines now being promulgated by the Agency for Health Care Policy and Research face the same difficulties.

REFERENCES

Greco PJ, Eisenberg JM.  Changing physicians' practices. N Engl J Med . 1993;;329:1271-1273.
Kosecoff J, Kanouse DE, Rogers WH, McCloskey L, Winslow CM, Brook RH.  Effects of the National Institutes of Health Consensus Development Program on physician practice. JAMA . 1987;;258:2708-2713.
Lomas J, Anderson GM, Domnick-Pierre K, Vayda E, Enkin MW, Hannah WJ.  Do practice guidelines guide practice? the effect of a consensus statement on the practice of physicians. N Engl J Med . 1989;;321:1306-1311.
Shorr RI, Fought RL, Ray WA.  Changes in antipsychotic drug use in nursing homes during implementation of the OBRA-87 regulations. JAMA . 1994;;271:358-362.
Garrard J, Lukas M, Dunham T, et al.  Evaluation of neuroleptic drug use by nursing home elderly under proposed Medicare and Medicaid regulations. JAMA . 1991;;265:463-467.
Kane RL, Williams CC, Williams TF, Kane RA.  Restraining restraints: changes in a standard of care. Annu Rev Public Health . 1993;;14:545-584.
Kane RL, Lurie N.  Appropriate effectiveness: a tale of carts and horses. QRB Qual Rev Bull . 1992;;18:322-326.
Phelps C.  The methodologic foundations of studies of the appropriateness of medical care. N Engl J Med . 1993;;329:1241-1245.
Kidder SW.  Cost-benefit of pharmacist-conducted drug-regimen reviews. Consult Pharmacist . 1987;;2:394-398.
Russell LB, Manning CL.  The effect of prospective payment on Medicare expenditures. N Engl J Med . 1989;;320:439-444.
Page RG.  The three-year medical curriculum. JAMA . 1970;;213:1012-1015.
Page RG, Boulger JG.  An assessment of the three-year medical curriculum. J Med Educ . 1976;;51:125-126.
Lomas J, Enkin M, Anderson GM, Hannah WJ, Vayda E, Singer J.  Opinion leaders vs audit and feedback to implement practice guidelines: delivery after previous cesarean section. JAMA . 1991;;265:2202-2207.
Soumerai SB, Avorn J.  Principles of educational outreach ('academic detailing') to improve clinical decision making. JAMA . 1990;;263:549-556.

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Greco PJ, Eisenberg JM.  Changing physicians' practices. N Engl J Med . 1993;;329:1271-1273.
Kosecoff J, Kanouse DE, Rogers WH, McCloskey L, Winslow CM, Brook RH.  Effects of the National Institutes of Health Consensus Development Program on physician practice. JAMA . 1987;;258:2708-2713.
Lomas J, Anderson GM, Domnick-Pierre K, Vayda E, Enkin MW, Hannah WJ.  Do practice guidelines guide practice? the effect of a consensus statement on the practice of physicians. N Engl J Med . 1989;;321:1306-1311.
Shorr RI, Fought RL, Ray WA.  Changes in antipsychotic drug use in nursing homes during implementation of the OBRA-87 regulations. JAMA . 1994;;271:358-362.
Garrard J, Lukas M, Dunham T, et al.  Evaluation of neuroleptic drug use by nursing home elderly under proposed Medicare and Medicaid regulations. JAMA . 1991;;265:463-467.
Kane RL, Williams CC, Williams TF, Kane RA.  Restraining restraints: changes in a standard of care. Annu Rev Public Health . 1993;;14:545-584.
Kane RL, Lurie N.  Appropriate effectiveness: a tale of carts and horses. QRB Qual Rev Bull . 1992;;18:322-326.
Phelps C.  The methodologic foundations of studies of the appropriateness of medical care. N Engl J Med . 1993;;329:1241-1245.
Kidder SW.  Cost-benefit of pharmacist-conducted drug-regimen reviews. Consult Pharmacist . 1987;;2:394-398.
Russell LB, Manning CL.  The effect of prospective payment on Medicare expenditures. N Engl J Med . 1989;;320:439-444.
Page RG.  The three-year medical curriculum. JAMA . 1970;;213:1012-1015.
Page RG, Boulger JG.  An assessment of the three-year medical curriculum. J Med Educ . 1976;;51:125-126.
Lomas J, Enkin M, Anderson GM, Hannah WJ, Vayda E, Singer J.  Opinion leaders vs audit and feedback to implement practice guidelines: delivery after previous cesarean section. JAMA . 1991;;265:2202-2207.
Soumerai SB, Avorn J.  Principles of educational outreach ('academic detailing') to improve clinical decision making. JAMA . 1990;;263:549-556.
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To understand the clinical management of acute heart failure syndromes.
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