Grant: Travel Awards - Institute Community Support

One approach to improving quality of healthcare is known as Audit and Feedback: this involves providing healthcare professionals with data on how often they follow best practices. We are conducting a study to investigate whether presenting the same feedback in different ways has differing effects on practice change. Part of this study involves investigating how feedback changes what physicians working in long-term care think about their own prescribing of high-risk medications, and the factors shaping how physicians use this feedback. Thirty-three physicians completed a questionnaire assessing their intention to adjust their prescribing; their confidence in adjusting their prescribing; their expectations that adjusting prescribing is beneficial for patient health; whether adjusting prescribing is a priority; and whether they thought other physicians were adjusting prescribing. We compared the responses of those who received different versions of the feedback. Five of these physicians also took part in an interview about their use of the feedback. We found that physicians whose feedback was compared to provincial average prescribing rates were more likely to agree that other physicians are adjusting antipsychotic prescribing, compared to physicians whose feedback was compared to the top performers. There were no other differences. All physicians interviewed reported aiming to achieve similar prescribing rates to their comparator. Also, physicians whose feedback was positively framed (reporting the number of patients for whom high-risk medications were not prescribed) reported not perceiving such feedback to be immediately actionable. In conclusion, the feedback did not greatly alter what physicians thought about their practice, and there were few differences across different versions of the feedback. Further work is needed to identify features of feedback which may have differing effects.