Table 1.

Summary of evidence base for prescribing interventions

Educational visiting or outreach	Has consistently been shown to improve prescribing [7] and in one study was shown to (academic detailing) improve health outcomes [8].
Clinical audit	Both computer-assisted and manual clinical audit have been shown to improve prescribing behaviour [9,10].
Mailed feedback of prescribing data	Mailed feedback alone was not found to change behaviour [11] but feedback accompanied by specific recommendations was more successful [12].
Interactive peer group meetings	An education programme involving audit feedback in peer groups saw larger changes in prescribing for acute situations and smaller changes for chronic therapy [13].
Problem-based learning using case  scenarios	A study of problem-based, face-to-face, small-group education on drug treatment found sustained improvement in prescribing of antibiotics [14].
Opinion leaders	Local opinion leaders were shown to accelerate adoption of effective treatments in general practice where best practice was clearly defined by evidence [15].
Written material	Variable effect alone but is additive with other interventions [16].
Guidelines	Locally adapted and implemented guidelines have been shown to change the prescribing behaviour of doctors [17].
Computer-assisted prompts	Well-designed reminders and alert systems coupled with an electronic health record have been shown to reduce initiation of inappropriate medication [18–20].