{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T15:10:56Z","timestamp":1785856256084,"version":"3.56.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T00:00:00Z","timestamp":1726704000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Danish Institute for Quality and Accreditation in Health Care"},{"name":"Danish Regions and the Organization of General Practitioners in Denmark"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Accreditation has been implemented in general practice in many countries as a tool for quality improvement. Evidence of the effects of accreditation is, however, lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To investigate the clinical effects of accreditation in general practice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design and setting<\/jats:title>\n                  <jats:p>A mandatory national accreditation programme in Danish general practice was rolled out from 2016 to 2018. General practices were randomized to year of accreditation at the municipality level.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a pragmatic randomized controlled study with general practices randomized to accreditation in 2016 (intervention group) and 2018 (control group). Data on patients enlisted with these practices were collected at baseline in 2014 (before randomization) and at follow-up in 2017. We use linear and logistic regression models to compare differences in changes in outcomes from baseline to follow-up between the intervention and control groups. The primary outcome was the number of redeemed medications. Secondary outcomes were polypharmacy, nonsteroidal anti-inflammatory drugs (NSAIDs)\u00a0without proton pump inhibitors, sleeping medicine, preventive home visits, annual controls, spirometry tests, and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We found statistically significant effects of accreditation on the primary outcome, the number of redeemed medications, and the secondary outcome, polypharmacy. No other effects were detected.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this first randomized study exploring the effects of accreditation in a primary care context, accreditation was found to reduce the number of redeemed medications and polypharmacy. We conclude that accreditation can be effective in changing behaviour, but the identified effects are small and limited to certain outcomes. Evaluations on the cost-effectiveness of accreditation are therefore warranted.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/fampra\/cmae049","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T05:04:52Z","timestamp":1726722292000},"source":"Crossref","is-referenced-by-count":1,"title":["Clinical effects of accreditation in general practice: a pragmatic randomized controlled study"],"prefix":"10.1093","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6804-2045","authenticated-orcid":false,"given":"Line B","family":"Pedersen","sequence":"first","affiliation":[{"name":"The Research Unit for General Practice, Department of Public Health, University of Southern Denmark , Odense ,","place":["Denmark"]},{"name":"DaCHE\u2014Danish Centre for Health Economics, Department of Public Health, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merethe K","family":"Andersen","sequence":"additional","affiliation":[{"name":"The Research Unit for General Practice, Department of Public Health, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Wehberg","sequence":"additional","affiliation":[{"name":"The Research Unit for General Practice, Department of Public Health, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkert","family":"Siersma","sequence":"additional","affiliation":[{"name":"The Research Unit for General Practice and The Section of General Practice, Department of Public Health, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[{"name":"The Research Unit for General Practice, Department of Public Health, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius B","family":"Kousgaard","sequence":"additional","affiliation":[{"name":"The Research Unit for General Practice and The Section of General Practice, Department of Public Health, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina D","family":"Due","sequence":"additional","affiliation":[{"name":"The Research Unit for General Practice and The Section of General Practice, Department of Public Health, University of Copenhagen , Copenhagen ,","place":["Denmark"]},{"name":"The Mental health services in the Capital Region of Denmark , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Reventlow","sequence":"additional","affiliation":[{"name":"The Research Unit for General Practice and The Section of General Practice, Department of Public Health, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flemming","family":"Bro","sequence":"additional","affiliation":[{"name":"The Research Unit for General Practice, Department of Public Health, Aarhus University , Aarhus,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans B","family":"Waldorff","sequence":"additional","affiliation":[{"name":"The Research Unit for General Practice, Department of Public Health, University of Southern Denmark , Odense ,","place":["Denmark"]},{"name":"The Research Unit for General Practice and The Section of General Practice, Department of Public Health, University of Copenhagen , Copenhagen 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