Infectious Disease

Some types of nudges can encourage compliance with the guidelines

October 05, 2021

Read for 2 minutes

Source / information

Source:
Nwafor O, et al. Soc Sci Med. 2021; doi: 10.1016 / j.socscimed.2021.114321.

Disclosure:
Healio Primary Care was unable to confirm any relevant financial information at the time of publication.

ADD SUBJECT TO EMAIL ALERTS

Receive an email when new articles are published on

Please enter your email address to receive an email when new articles are published on . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If this problem persists, please contact [email protected].

Back to Healio

Clinical nudges that aimed to make information more meaningful, provide feedback, and implement standard order sets in electronic systems have been “generally effective” at promoting compliance, the researchers wrote.

However, the systematic review lacked data on the effectiveness of other types of nudges, including “likely error reduction, structuring complex problems, and understanding mapping”. Onyi Nwafor, PhD, an assistant professor at the Bryan School of Business and Economics, University of North Carolina at Greensboro, and colleagues wrote in social sciences and medicine.

Reference: Nwafor O, et al. Soc Sci Med. 2021; doi: 10.1016 / j.socscimed.2021.114321.

“We also found that this literature mainly focuses on whether nudge interventions work, with little emphasis on organizational issues such as cost-effectiveness, impact on health workers, and disruptions to established workflows and routines,” the researchers continued.

Clinical nudges are “subtle changes in the way decisions are presented that can significantly affect a decision-maker in predictable ways without limiting choices,” Nwafor told Healio Primary Care.

For example, to reduce unnecessary antibiotic prescriptions, Nwafor said that doctors’ prescribing behavior can be influenced by decisions that appear as preset options in an electronic order entry system.

Onyi Nwafor

“The specification of standard settings in an electronic order entry system with preferred drugs and dosages probably promotes the desired prescribing behavior due to a so-called status quo bias – or the innate preference of decision-makers for the current state of affairs (status quo.). ) believing that any change in the status quo is less beneficial, ”she said.

However, Nwafor cautioned that impetus could have “unintended effects”. A previous review of 17 studies showed that EHR warnings aimed at improving drug safety were overridden by clinicians in 49 to 96% of cases.

“While warnings can generally encourage compliance, they can also lead to warning fatigue, a phenomenon where too many warnings can lead to cognitive overload and subsequent failure of a decision maker, the relevance of the warning to the current situation Recognize, “she said.” Alert fatigue can lead health professionals to create potentially harmful workarounds or overrides while using the EHR. It can also lead to job dissatisfaction. “

Still, she said health care workers might consider using impetus to improve policy compliance. In addition, the data from the 83 studies that she and her colleagues analyzed could have broader effects on health workers, such as:

“The evidence from our study suggests that careful design or drafting of communication messages in a way that highlights the benefits of vaccination (ie gains) rather than the risks (ie losses) promotes vaccine adoption among health professionals can. “,” She said. “Another communication strategy that our study has shown to be generally effective is the inclusion of peer-to-peer information about vaccination rates from other health workers or organizations in an area.”

Going forward, researchers wrote that they hope to create a focal point for evidence on nudges that can help policymakers and health administrators develop and manage interventions that “encourage guideline-compliant behavior.”

References

Nwafor O, et al. Soc Sci Med. 2021; doi: 10.1016 / j.socscimed.2021.114321.

van der Sijs, H, et al. J Am Med Inform Assoc. 2006; doi: 10.1197 / jamia.M1809.

ADD SUBJECT TO EMAIL ALERTS

Receive an email when new articles are published on

Please enter your email address to receive an email when new articles are published on . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If this problem persists, please contact [email protected].

Back to Healio

Related Articles