'Mind tactics' on doctors are tripling opioid prescribing

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Tactics from the world of behavioural science are being used on doctors to encourage them to prescribe more drugs, such as statins, opioids and the flu vaccine.

Doctors who are exposed to techniques such as 'nudges' triple the number of prescriptions they write out, a new study has discovered.

Nudges and other techniques from the world of behavioural science are being built into software systems that doctors access when they are treating patients. Two common 'nudges' are reminders at the point when the doctor decides on the next steps and later when their prescribing levels are compared to those of other doctors.

The techniques are tripling the number of prescriptions being written, say researchers from the University of Pennsylvania's School of Medicine.


They were monitoring the impact of nudges on statin-prescribing, but the techniques are also used for prescribing opioids, cancer screening and the flu vaccine. They said the techniques achieved a "significant increase" in the number of prescriptions being written.

The researchers tracked the prescribing levels of 96 doctors who were caring for 4,774 patients, all of whom were 'eligible' for statins but weren't taking them. The doctors who didn't get any 'nudges' prescribed drugs to just 40 patients, but this number leapt to 117 patients when nudging was switched on.

The idea of 'nudging' is to intervene in small and subtle ways to change the decisions being made. The researchers recommend that they are built into every healthcare system so that prescriptions increase.

(Source: JAMA Network Open, 2018; 1: e180818)

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