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Table 1 Studies included in the Review with specifications of implementation strategies and efficacy of treatment and costs

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

Authors, year Research design Evidence quality Study characteristics: Population; i+c gr. (A) Participants (B) Stakeholders (C) Method characteristics: Intervention type (A) Content guideline (B) Practical Attributes (C) Implementation strategy Results treatment Results costs
41. Bursey & Crowley 2000 Dynamic population cohort B A: 110.000 residents of NF-land, Canada B: All GPs C: Government A: Authorisation program for reimbursement. B: Patient selection for PPI use. C: Algorithm for prescription management. I. passive > 80% decrease PPI PPI < 82% ($1.3 mil) first year; <62% after 2 years. ASD <36% ($2.0 mil) first year; <16% after 2 years
42. Ladabaum & Fendrick 2001 Prospective multicentre trial. B A: P. ulcer patients (54+39) B: PC-centres (3+3), GPs? C: University Michigan. A: Interactive sessions by GE. B: Test & treat strategy C: H. pylori serological test for PC. III. multiple 32% more tests; same referrals; 31% less prescriptions (p > .001) 79% in intervention group ($ 122 pp) (p = .17)
43. Chan & Patel 2001 RCT A2 A: All dyspepsia patients B: GPs (133+146); voluntary Hampshire C: Health authority A: Posted guidelines and reinforcement visits by NP B: Management dyspepsia, H pylori. C: Wall chart, booklet III. multiple - 5% decrease in medication
44. Huren-kamp & Grund-meijer 2001 RCT A2 A: H. pylori patients (89/85) B: 48 GP practices, voluntary C: University Amsterdam A: Education of protocol; support by NP. B: Tapering prescriptions of ASD by doses and on demand treatment. C: follow up patients by NP. III. multiple Decrease of 1,5 PDD; 40% stopped ASD (ns); More HP neg, more H2RA -
45. Weynen & de Wit 2002 RCT Cluster A2 A: 260 (99/73/88) patients B: 28 GPs; voluntary C: University Utrecht A: Education program, financial incentives and personal feedback. B: H. Pylori diagnosis and treatment C: Dyspepsia questionnaire, HP test. III. multiple 17% better follow-up (ns), in incentive group Less overall costs (€46 pp; ns) in incentive group
46. Banait & Sibbald 2003 RCT cluster, A2 A: Practice population (265.000) B: GP practices (57+56); voluntary NW England. C: University, GE, Health authorities. A: Posted guidelines with education outreach and follow-up visit. B: Clinical strategies for referral. C: Open access to endo-scopies and serological tests III. multiple 14% more referrals, 4 more tests/practice 6% more costs ASD
47. Jones & Lydeard 1993 RCT, A2 A: Practice population (500.000) B: GPs (78+101); voluntary; Southampton C: Consensus group GP+GE A: Consensus meetings GP-SP. B: Investigation and refer dyspepsia; appropriate use of guidelines. C: reference cards, II. single No difference in referrals and endoscopies 22% more prescribing costs
48. Allison & Hurley 2003 RCT A2 A: ASD patients (321+329). B: Physicians from study C: HMO California A: Test & treatment random group. B: T&T protocol C: Detailed instructions II single Less ulcerlike symptoms and abdominal pain; 8% less users' medication Higher costs because of HP treatment (not hospital)
49. Kearney & Liu 2004 Follow up Cohort B A: ASD patients (432) B: GE from study C: MHO Seattle A: Patient Interview and HP test B: Hospital stopped ASD medicine C: Instruction for GPs' review. I. passive 71% ulcer; 29% dyspepsia; number stopped? Hospital $34 less pp; Medication ns; Only ulcer cases
50. Krol & Wensing 2004 RTC cluster A2 A: ASD patients (63+50) B: 20 GP practices voluntary C: University Utrecht A: Direct mail to patients to reduce ASD. B: Postal instructions for patients. C: Instruction and flowchart II single 17% reduction (10% stopped); no change in symptoms and quality -