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Research Letter
June 4, 2019

Association of Quetiapine Overuse Letters With Prescribing by Physician Peers of Targeted Recipients: A Secondary Analysis of a Randomized Clinical Trial

Author Affiliations
  • 1Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, New York
  • 2National Bureau of Economic Research, Cambridge, Massachusetts
  • 3Department of Economics, Columbia University, New York, New York
  • 4Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
JAMA Psychiatry. Published online June 4, 2019. doi:10.1001/jamapsychiatry.2019.1418

Physicians learn about new medical evidence from their peers.1,2 Interventions that can stem overuse in some physicians could therefore spur systemwide change through peer networks as physicians discuss new practice styles and learn from each other. One source of overuse is antipsychotic prescribing: these drugs are widely prescribed to people with dementia even though guidelines discourage this practice.3 A randomized clinical trial of antipsychotic overuse letters that were sent by the Centers for Medicare and Medicaid Services (CMS) to high prescribers of quetiapine reduced prescribing by targeted physicians by 16% over 2 years (NCT02467933).4 This study examines whether these letters led to changes in prescribing by peers of the original physicians, which would suggest that overuse interventions can have broader effects.

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