Nudge Letters to GPs Show Strong Impact on Test Ordering

Nudge Letters to GPs Show Strong Impact on Test Ordering

21 May 2026

The study showed that targeted written feedback to GPs who were among the highest users of certain pathology test combinations led to a 36% drop in overall test requests over six months. The reduction remained strong at around 32% after 12 months.

The research, published in The Lancet, analysed 5,339 GPs identified as high requestors for commonly overused tests such as iron studies, thyroid function tests, vitamin D, and vitamin B12 between 2019 and 2021.

Doctors in the intervention group received personalised audit and feedback letters from Australia’s Chief Medical Officer, while a control group received no feedback.

Researchers found that adding extra materials like education resources, cost information, or redesigned pamphlets did not improve results beyond the effect of the letter alone.

Experts involved in the study said the reduction in unnecessary testing was substantial, with tens of thousands fewer tests ordered over the study period.

They also noted that over-requesting can lead to false positives, unnecessary follow-up tests, patient anxiety, and increased pressure on healthcare resources.

The Department of Health, Disability and Ageing said the approach focuses on improving the appropriate use of Medicare-funded services through education, engagement, and early identification of inappropriate practice.

https://www1.racgp.org.au/

Source: The Lancet; evaluation of Australian Department of Health, Disability and Ageing audit and feedback program (2022–23)

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