Drug treatment of stable angina pectoris and mass dissemination of therapeutic guidelines: a randomized controlled trial

被引:13
作者
Beaulieu, MD
Brophy, J
Jacques, A
Blais, R
Battista, R
Lebeau, R
机构
[1] CHU Montreal, Ctr Rech, Chaire Dr Sadok Besrour Med Familiale, Montreal, PQ, Canada
[2] McGill Univ, Ctr Hlth, Div Cardiol, Montreal, PQ, Canada
[3] McGill Univ, Ctr Hlth, Div Clin Epidemiol, Montreal, PQ, Canada
[4] Univ Montreal, Coll Med Quebec, Montreal, PQ, Canada
[5] Univ Montreal, Dept Adm Sante, Montreal, PQ, Canada
[6] Agcy Evaluat Technol & Intervent Sante, Montreal, PQ, Canada
基金
英国医学研究理事会;
关键词
D O I
10.1093/qjmed/hch006
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Public agencies responsible for implementing health care policies often adapt and disseminate clinical practice guidelines, but the effectiveness of mass dissemination of guidelines is unknown. Aim: To study the effects of guideline dissemination on physicians' prescribing practices for the treatment of stable angina pectoris. Design: Randomized controlled trial. Methods: A sample of 3293 Quebec physicians were randomly assigned to receive a one-page summary of clinical practice guidelines on the treatment of stable angina (in February 1999), to receive the summary and a reminder (in February and March 1999, respectively), or to receive no intervention (controls). The prescribing profiles of participants, as well as sociodemographic characteristics of the physicians and their patients, were examined for June-December 1999. Results: The intervention had no effect on prescription rates of beta-blockers, antiplatelet agents, or hypolipaemic drugs. Compared to 1997 data for the same physicians, there was an overall 10% increase in appropriate prescription rates, irrespective of the intervention. Discussion: In-house production and dissemination of clinical practice guidelines may not improve physicians' practice patterns if there is pre-existing substantial scientific, consensus on the issue.
引用
收藏
页码:21 / 31
页数:11
相关论文
共 23 条
  • [1] [Anonymous], 1962, DIFFUSION INNOVATION
  • [2] Beaulieu MD, 1999, CAN MED ASSOC J, V161, P519
  • [3] Are patients suffering from stable angina receiving optimal medical treatment
    Beaulieu, MD
    Blais, R
    Jacques, A
    Battista, RN
    Lebeau, R
    Brophy, J
    [J]. QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, 2001, 94 (06) : 301 - 308
  • [4] Bero LA, 1998, BMJ-BRIT MED J, V317, P465
  • [5] *CONS CONS PHARM, 1996, TRAIT PHARM ANG STAB
  • [6] Diller PM, 1999, J FAM PRACTICE, V48, P188
  • [7] Differences between primary care physicians and cardiologists in management of congestive heart failure: Relation to practice guidelines
    Edep, ME
    Shah, NB
    Tateo, IM
    Massie, BM
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1997, 30 (02) : 518 - 526
  • [8] FREEDHOFF MI, 1997, HDB OPTICAL PROPERTI, V2, P1
  • [9] GIBBONS RJ, 2002, GUIDELINES MANAGEMEN
  • [10] Does knowledge of drug prescribing predict drug management of standardized patients in office practice?
    Grad, R
    Tamblyn, R
    McLeod, PJ
    Snell, L
    Illescas, A
    Boudreau, D
    [J]. MEDICAL EDUCATION, 1997, 31 (02) : 132 - 137