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Interventional pharmacoepidemiology: design and evaluation of interventions to improve prescribing.

Alexander, G. Caleb; Grant, Aileen; Hughes, Carmen; Dreischulte, Tobias


G. Caleb Alexander

Carmen Hughes

Tobias Dreischulte


Despite the value of modern therapeutics, many obstacles prevent their optimal use. Overuse, underuse and misuse are common, resulting in morbidity and mortality impacting billions of individuals across the world. Pharmacoepidemiology provides important insights into drug utilization, safety and effectiveness in large populations, and it is an important method to identify opportunities to improve the value of therapeutics in clinical practice. However, for these opportunities to be realized, interventions to improve prescribing must be developed, evaluated and implemented in the real world. We provide an overview of this process, focusing especially on how such interventions can be designed and deployed to maximize scalability, adoption and impact. Prescribing represents a complex behavior with barriers and enablers, and interventions to improve prescribing will be most successful when developed, piloted and refined to maximize provider and patient acceptability. Carefully developed evaluations of interventions are also critical, and varied methods are available to empirically evaluate the intended and potential unintended consequences of interventions. With illustrative examples from the peer-reviewed literature, we provide readers with an overview of approaches to the essential and growing field of interventional pharmacoepidemiology.


ALEXANDER, C., GRANT, A., HUGHES, C. and DREISCHULTE, T. 2023. Interventional pharmacoepidemiology: design and evaluation of interventions to improve prescribing. American journal of epidemiology [online], (accepted).

Journal Article Type Article
Acceptance Date Oct 26, 2023
Deposit Date Jan 12, 2024
Journal American journal of epidemiology
Print ISSN 0002-9262
Electronic ISSN 1476-6256
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Keywords Interventions; Prescription drugs; Prescribing quality; Prescribing indicators
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