Who cares what other people are prescribing? Peer feedback impacts choices

Does knowing about peers’ prescribing habits influence an individual’s choices? It seems so. A study published in the American Journal of Psychiatry investigated if peer comparison letters targeting high-volume primary care prescribers of quetiapine resulted in reduced prescribing of the drug. Prescribers were received a “placebo” letter or 3 peer-comparison letters stating that their quetiapine prescribing was high relative to their peers and was under review. Those in the intervention arm supplied 11.1% fewer quetiapine days per prescriber compared to the control arm. Patients in the active arm received 3.9% fewer days of quetiapine over 9 months, with a larger decrease among patients with low-value vs guideline-concordant indications. There was no evidence of substitution to other antipsychotics, and 9-month mortality and hospital use were similar between the treatment vs control arms.