Journal of evaluation in clinical practice
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Randomized Controlled Trial
Electronic prescribing in an ambulatory care setting: a cluster randomized trial.
Medication-prescribing errors with adverse drug events impose substantial harms on patients and health systems. Medication errors resulting in preventable adverse drug events most commonly occur at the ordering stage. Electronic prescribing may prevent such errors but its impact has not been rigorously evaluated. ⋯ Implementation of the electronic prescribing system had no impact on total prescription error, and increased the callback rate. In spite of intensive user support, few prescriptions in intervention weeks were made using the electronic system. Given the costs, training requirements, workflow redesigns and regulatory hurdles, additional evaluations of outpatient prescribing on clinically important outcomes are needed.
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Randomized Controlled Trial
Increasing heart-health lifestyles in deprived communities: economic evaluation of lay health trainers.
Cardiovascular disease (CVD) often arises from modifiable lifestyle factors. Health care professionals may lack the skills and resources to sustain behaviour change, lay 'health trainers' (LHT) offer a potential alternative. We sought to assess the cost-effectiveness of using a LHT to improve heart-health lifestyles in deprived communities. ⋯ LHT provision was estimated to be cost-effective for people at risk of CVD. However, a large level of uncertainty was associated with that decision.
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Randomized Controlled Trial
C-reactive protein point of care testing and physician communication skills training for lower respiratory tract infections in general practice: economic evaluation of a cluster randomized trial.
An economic evaluation of general practitioner (GP) use of C-reactive protein (CRP) point of care test, GP communication skills training, and both GP use of CRP and communication skills training on antibiotic use for lower respiratory tract infections (LRTIs) in general practice. ⋯ The two strategies, both singly and combined, are cost-effective interventions to reduce antibiotic prescribing for LRTI, at no, or low willingness-to-pay. Taking GP preferences into account will optimize investment in strategies to reduce antibiotic prescribing for LRTI.
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Randomized Controlled Trial
Clinician's use of the Statin Choice decision aid in patients with diabetes: a videographic study nested in a randomized trial.
To describe how clinicians use decision aids. ⋯ Unintended decision aid use in the context of videotaped encounters in a practical randomized trial was common. These instances offer insights to researchers seeking to design and implement effective decision aids for use during the clinical visit, particularly when clinicians may prefer to proceed in ways that the decision aid apparently contradicts.
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Randomized Controlled Trial
A randomized controlled trial of an at-home preparation programme for Japanese preschool children: effects on children's and caregivers' anxiety associated with surgery.
To determine whether the implementation of at-home psychological preparation programme for children and family prior to surgery can reduce anxiety for Japanese preschool children undergoing herniorrhaphy and their caregivers assessed as an appropriate outpatient care. ⋯ A specially designed at-home preparation programme as an outpatient care is effective to encourage parent-child verbal interaction concerning surgery and reduce both children and caregivers' anxiety associated with surgery.