eprintid: 10144263 rev_number: 7 eprint_status: archive userid: 699 dir: disk0/10/14/42/63 datestamp: 2022-02-25 11:47:54 lastmod: 2022-02-25 11:47:54 status_changed: 2022-02-25 11:47:54 type: article metadata_visibility: show sword_depositor: 699 creators_name: Talat, Usman creators_name: Schmidtke, Kelly Ann creators_name: Khanal, Saval creators_name: Chan, Amy creators_name: Turner, Alice creators_name: Horne, Robert creators_name: Chadborn, Tim creators_name: Gold, Natalie creators_name: Sallis, Anna creators_name: Vlaev, Ivo title: A Systematic Review of Nudge Interventions to Optimize Medication Prescribing ispublished: pub divisions: C08 divisions: G11 divisions: B02 divisions: UCL divisions: D10 keywords: behavioural science, medical decision-making, nudge, prescribing/use/costs, systematic reviews note: © 2022 Talat, Schmidtke, Khanal, Chan, Turner, Horne, Chadborn, Gold, Sallis and Vlaev. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/). abstract: BACKGROUND: The benefits of medication optimization are largely uncontroversial but difficult to achieve. Behavior change interventions aiming to optimize prescriber medication-related decisions, which do not forbid any option and that do not significantly change financial incentives, offer a promising way forward. These interventions are often referred to as nudges. OBJECTIVE: The current systematic literature review characterizes published studies describing nudge interventions to optimize medication prescribing by the behavioral determinants they intend to influence and the techniques they apply. METHODS: Four databases were searched (MEDLINE, Embase, PsychINFO, and CINAHL) to identify studies with nudge-type interventions aiming to optimize prescribing decisions. To describe the behavioral determinants that interventionists aimed to influence, data were extracted according to the Theoretical Domains Framework (TDF). To describe intervention techniques applied, data were extracted according to the Behavior Change Techniques (BCT) Taxonomy version 1 and MINDSPACE. Next, the recommended TDF-BCT mappings were used to appraise whether each intervention applied a sufficient array of techniques to influence all identified behavioral determinants. RESULTS: The current review located 15 studies comprised of 20 interventions. Of the 20 interventions, 16 interventions (80%) were effective. The behavior change techniques most often applied involved prompts (n = 13). The MINDSPACE contextual influencer most often applied involved defaults (n = 10). According to the recommended TDF-BCT mappings, only two interventions applied a sufficient array of behavior change techniques to address the behavioral determinants the interventionists aimed to influence. CONCLUSION: The fact that so many interventions successfully changed prescriber behavior encourages the development of future behavior change interventions to optimize prescribing without mandates or financial incentives. The current review encourages interventionists to understand the behavioral determinants they are trying to affect, before the selection and application of techniques to change prescribing behaviors. SYSTEMATIC REVIEW REGISTRATION: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42020168006]. date: 2022 date_type: published publisher: Frontiers Media SA official_url: https://doi.org/10.3389/fphar.2022.798916 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1939967 doi: 10.3389/fphar.2022.798916 medium: Electronic-eCollection pii: 798916 lyricists_name: Horne, Robert lyricists_id: RHORN95 actors_name: Horne, Robert actors_name: Harris, Jean actors_id: RHORN95 actors_id: JAHAR68 actors_role: owner actors_role: impersonator full_text_status: public publication: Frontiers in Pharmacology volume: 13 article_number: 798916 event_location: Switzerland citation: Talat, Usman; Schmidtke, Kelly Ann; Khanal, Saval; Chan, Amy; Turner, Alice; Horne, Robert; Chadborn, Tim; ... Vlaev, Ivo; + view all <#> Talat, Usman; Schmidtke, Kelly Ann; Khanal, Saval; Chan, Amy; Turner, Alice; Horne, Robert; Chadborn, Tim; Gold, Natalie; Sallis, Anna; Vlaev, Ivo; - view fewer <#> (2022) A Systematic Review of Nudge Interventions to Optimize Medication Prescribing. Frontiers in Pharmacology , 13 , Article 798916. 10.3389/fphar.2022.798916 <https://doi.org/10.3389/fphar.2022.798916>. Green open access document_url: https://discovery-pp.ucl.ac.uk/id/eprint/10144263/1/A%20Systematic%20Review%20of%20Nudge%20Interventions%20to%20Optimize%20Medication%20Prescribing.pdf