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[Reduction of the use of habit-forming drugs in Vest-Agder].

BACKGROUND
For several years, the county of Vest-Agder has been over the Norwegian average for sales of habit-forming prescription medication.


MATERIAL AND METHODS
A quasi-experimental project was implemented in an attempt to reduce prescription of habit-forming medication by general practitioners. 59% of eligible physicians participated in the ten-month project; 192 physicians were invited to participate, 114 accepted; 13 of these were excluded, primarily due to low weekly patient contact hours. All participating physicians received profiles of their own prescribing habits as well as the habits of other participating doctors in the region (anonymous). Physicians with a documented (via pharmacy registry) prescription rate of over 4,000 defined daily doses (DDD) per month were defined as heavy prescribers and offered a colleague-based counseling session regarding their prescribing habits.


RESULTS
A comparison of heavy prescribers (n = 9) with other participating physicians (n = 92) revealed that after ten months, prescription of habit forming medication was reduced 8.5% in heavy subscribers, while the other participating physicians increased their prescription rates by 2.1%. The reduction in DDD observed among heavy subscribers was accounted for by reductions in both the number of prescriptions and the number of DDD per prescription.


INTERPRETATION
Identification and feedback, rather than the colleague-based interview, seemed to be responsible for the reductions observed among heavy prescribers.