Improving prescribing practices in primary care: A randomised trial and economic analysis of a multicomponent intervention showed small, but important, gains

[Extract] In a new paper in PLoS Medicine, Fretheim and colleagues report the results of the Rational Prescribing in Primary Care (RaPP) trial, a cluster-randomised controlled trial of a multicomponent intervention to improve prescribing of antihypertensive and cholesterol-lowering drugs in primary care. In a second paper, the same authors present their economic evaluation of the intervention.

In the trial, the unit of randomization was the general practice, and the authors randomized 146 general practices from two geographical areas to the intervention or control. The multicomponent intervention included educational outreach visits to clinics to discuss clinical practice guidelines, an audit and feedback on current adherence to guidelines, and computerized reminders to doctors during patient consultations. The control intervention was passive dissemination of guidelines through a national medical journal.