Reducing Overprescribing Through Peer Comparison Letters

Antipsychotic agents, such as quetiapine fumarate, are frequently overprescribed for indications not supported by clinical evidence, potentially causing harm.  In this randomized clinical trial, a peer comparison letter randomized across the 5055 highest Medicare prescribers of the antipsychotic quetiapine fumarate reduced prescribing for at least 2 years. Effects were larger than those observed in existing large-scale behavioral interventions, potentially because of the content of the peer comparison letter, which mentioned the potential for a review of prescribing activity.  This indicates that behavioral nudge interventions can raise the quality of prescribing, but research is still needed on how to most precisely target unsafe prescribing behavior.

The full article, entitled "Effect of Peer Comparison Letters for High-Volume Primary Care Prescribers of Quetiapine in Older and Disabled Adults: A Randomized Clinical Trial" can be viewed here.