Journal of Continuing Education in the Health Professions



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CURRENT ISSUE BACK ISSUES SUBSCRIBE ADVERTISE ABOUT JCEHP FOR AUTHORS JCEHP AWARD SEARCH (Members only) FULL-TEXT		Volume 22 (1) Volume 22, Issue 1, Winter 2002 J Contin Educ Health Prof 2002; 22(1):11-22 ORIGINAL ARTICLES Can we alter physician behavior by educational methods? Lessons learned from studies of the management and follow-up of hypertension Tu K Davis D A b s t r a c t INTRODUCTION: As expectations for effective continuing medical education (CME) grow, so, too, does the need to identify relationships among educational methods, physician performance, and patient outcomes associated with specific disease entities. Thus, we set out to review the literature on the effectiveness of physician educational interventions in the management and follow-up of hypertension. METHOD: We searched PubMed and the Research and Development Resource Base in Continuing Medical Education for randomized controlled trials of physician educational interventions. We included only those studies that (a) used replicable educational interventions with > 50% physician involvement and that employed objective methods to measure physician behavior change or patient outcomes, (b) indicated a physician or patient dropout rate of < 30%, and (c) followed outcome measurement for > 30 days. Studies were designated "positive" if one or more of the primary outcome measures demonstrated a statistically significant change in physician performance or health care outcome. RESULTS: We found 12 studies in which 7 different physician educational interventions were employed, alone or in combination, including reminders (computer or chart), formal CME, computerized decision support systems/risk stratification, printed educational materials, academic detailing, continuous quality improvement projects, and disease management aids in patient charts. Of the 12, 7 were positive and 4 were negative. One had mixed results. DISCUSSION: Although physician educational interventions, especially reminders, improved the follow-up of hypertension, they were ineffective in changing blood pressure levels. However, they may have some utility in improving compliance with guideline recommendations. Lessons for Practice It is possible to improve specific aspects of individual disease states, in this case, hypertension. To effect improvement, most success will likely be found if efforts are target-ed at one aspect of a given disease. The intervention that is likely to be most successful will depend on the identified aspect to be changed and the feasibility in the given setting. MeSH Terms: Decision Support Systems, Clinical; Education, Medical, Continuing; Guideline Adherence; Hypertension; Outcome Assessment (Health Care); Physician's Practice Patterns; Randomized Controlled Trials; Reminder Systems; Support, Non-U.S. Gov't; Total Quality Management Publication Type: Review
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