Display options
Cite
Csonka P, Heikkilä P, Koskela S, et al. Cough and cold medicine prescription rates can be significantly reduced by active intervention. Eur J Pediatr. 2021;doi: 10.1007/s00431-021-04344-0.
Csonka, P., Heikkilä, P., Koskela, S., Palmu, S., Lajunen, N., Riihijärvi, S., Huhtala, H., & Korppi, M. (2021). Cough and cold medicine prescription rates can be significantly reduced by active intervention. European journal of pediatrics, . https://doi.org/10.1007/s00431-021-04344-0
Csonka, Péter, et al. "Cough and cold medicine prescription rates can be significantly reduced by active intervention." European journal of pediatrics vol. (2021). doi: https://doi.org/10.1007/s00431-021-04344-0
Csonka P, Heikkilä P, Koskela S, Palmu S, Lajunen N, Riihijärvi S, Huhtala H, Korppi M. Cough and cold medicine prescription rates can be significantly reduced by active intervention. Eur J Pediatr. 2021 Dec 15; doi: 10.1007/s00431-021-04344-0. Epub 2021 Dec 15. PMID: 34913111; PMCID: PMC8673918.
Copy Download .nbib Format: NLM
Share it on

Eur J Pediatr. 2021 Dec 15; doi: 10.1007/s00431-021-04344-0. Epub 2021 Dec 15.

Cough and cold medicine prescription rates can be significantly reduced by active intervention.

European journal of pediatrics

Péter Csonka, Paula Heikkilä, Sonja Koskela, Sauli Palmu, Noora Lajunen, Sari Riihijärvi, Heini Huhtala, Matti Korppi

Affiliations

  1. Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Arvo Ylpönkatu 34 (ARVO B235), 33014, Tampere, Finland. [email protected].
  2. Terveystalo Healthcare, Tampere, Finland. [email protected].
  3. Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Arvo Ylpönkatu 34 (ARVO B235), 33014, Tampere, Finland.
  4. Terveystalo Healthcare, Helsinki, Finland.
  5. Faculty of Social Sciences, Tampere University, Tampere, Finland.

PMID: 34913111 PMCID: PMC8673918 DOI: 10.1007/s00431-021-04344-0

Abstract

Our aim was to construct and test an intervention programme to eradicate cough and cold medicine (CCM) prescriptions for children treated in a nationwide healthcare service company. The study was carried out in the largest private healthcare service company in Finland with a centralised electronic health record system allowing for real-time, doctor-specific practice monitoring. The step-by-step intervention consisted of company-level dissemination of educational materials to doctors and families, educational staff meetings, continuous monitoring of prescriptions, and targeted feedback. Outreach visits were held in noncompliant units. Finally, those physicians who most often prescribed CCM were directly contacted. During the intervention period (2017-2020), there were more than one million paediatric visits. Prescriptions of CCMs to children were completely eradicated in 41% of units and the total number of CCM prescriptions decreased from 6738 to 744 (89%). During the fourth intervention year, CCMs containing opioid derivatives were prescribed for only 0.2% of children aged < 2 years. The decrease in prescriptions was greatest in general practitioners (5.2 to 1.1%). In paediatricians, the prescription rates decreased from 1.5 to 0.2%. The annual costs of CCMs decreased from €183,996 to €18,899 (89.7%). For the intervention, the developers used 343 h and the attended doctors used 684 h of work time during the 4-year intervention. The costs used for developing, implementing, reporting, evaluating, communicating, and data managing formed approximately 11% of total intervention costs.Conclusion: The study showed that a nationwide systematic intervention to change cough medicine prescription practices is feasible and requires only modest financial investments. What is Known: • Cough and cold medicines (CCM) are not effective or safe, especially for children aged 6 years. • Although the use of CCMs has been declining, caregivers continue to administer CCMs to children, and some physicians still prescribe them even for preschool children. What is New: • A nationwide systematic intervention can significantly and cost effectively change CCM prescription habits of paediatricians, general practitioners, and other specialists. • Electronic health records provide additional tools for operative guideline implementation and real-time quality monitoring, including recommendations of useless or harmful treatments.

© 2021. The Author(s).

Keywords: Clinical practice; Cough medicine; Expectorants; Guideline implementation; Healthcare practice; Intervention; Quality assessment

References

  1. Implement Sci. 2009 Aug 12;4:54 - PubMed
  2. Clin Pediatr (Phila). 2020 Oct;59(11):988-994 - PubMed
  3. JAMA Pediatr. 2021 Aug 1;175(8):797-806 - PubMed
  4. J Pediatr. 2014 Nov;165(5):1024-8.e1 - PubMed
  5. Pediatrics. 2017 Mar;139(3): - PubMed
  6. JAMA. 1999 Oct 20;282(15):1458-65 - PubMed
  7. Lancet. 2003 Oct 11;362(9391):1225-30 - PubMed
  8. Pediatrics. 2014 May;133(5):e1233-40 - PubMed
  9. Postgrad Med J. 1996 Jan;72(843):19-22 - PubMed
  10. Pediatrics. 2013 Dec;132(6):1047-54 - PubMed
  11. Eur Respir J. 2020 Jan 2;55(1): - PubMed
  12. BMJ. 2013 Dec 11;347:f7027 - PubMed
  13. Cochrane Database Syst Rev. 2016 Jul 13;7:CD011914 - PubMed
  14. Am J Respir Crit Care Med. 1997 Jun;155(6):1935-9 - PubMed
  15. Acta Paediatr. 2018 Nov;107(11):1966-1970 - PubMed
  16. Pediatr Infect Dis J. 2020 Dec;39(12):e423-e427 - PubMed
  17. Acta Paediatr. 2021 Aug;110(8):2445-2447 - PubMed
  18. Cochrane Database Syst Rev. 2014 Nov 24;(11):CD001831 - PubMed
  19. Pediatrics. 2014 Jan;133(1):e227-34 - PubMed
  20. BMC Fam Pract. 2013 Jul 28;14:106 - PubMed
  21. J Pain Symptom Manage. 2011 Oct;42(4):623-31 - PubMed
  22. JAMA Pediatr. 2019 Sep 1;173(9):885-887 - PubMed
  23. Pediatrics. 2014 May;133(5):e1139-47 - PubMed

Publication Types