Effectiveness of the Feedback and Recalling Education on Quality of Prescription by General Practitioners in Shiraz

Background: Although there is a great concern regarding rational use of drugs, the available
evidence for the appropriate strategies to improve prescribing is scarce in Iran. The goal of the
this study was to assess the prescribing pattern of general practitioners (GPs) in Fars province
(Shiraz) and evaluate the effectiveness of the combination of feedback of individualized prescribing
and workshop training programs.
Materials and Methods: A quasi experimental intervention study was conducted in which
prescription copies of 119 GPs before and after intervention were compared. Physicians received
individual instruction with specific recommendations or participated in a training workshop for
improvement according to their baseline prescribing quality levels. The paired t-test was used to
compare before and after results.
Results: The most frequently prescribed drugs were injectable drugs (58.8%) and antibiotics
(47.3%). A trend toward increasing rational drug prescriptions was observed in most
pharmacological components of prescriptions. Over-prescription of injectable and non-steroidal
anti-inflammatory (NSAIDs) drugs showed statistically significant decrease, but the antibiotics
showed no significant change. Unusual dose of antibiotic, concurrent prescribing of H2-blocker
and Omeprazol and first degree drug-interaction also decreased significantly.
Discussion: The intervention showed that improving the quality of prescribing was feasible,
particularly in over-prescribing