An educational programme for peer review groups to improve treatment of chronic heart failure and diabetes mellitus type 2 in general practice.

Rationale, aims and objectives Peer review groups are considered helpful for quality improvement in primary care. An interactive educational programme for small peer groups was developed, focusing on the implementation of newly developed treatment guidelines. The aim is to evaluate the effect of the...

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Publicado en:Journal of Evaluation in Clinical Practice Vol. 12; no. 6; pp. 613 - 622
Autores principales: Kasje WN, Denig P, Stewart RE, de Graeff PA, Haaijer-Ruskamp FM
Formato: algorithm clinical trial research Journal Article
Publicado: Wiley-Blackwell Dec2006
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2006
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/j.1365-2753.2005.00625.x
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        atl: An educational programme for peer review groups to improve treatment of chronic heart failure and diabetes mellitus type 2 in general practice.
      aug:
        au:
          Kasje WN
          Denig P
          Stewart RE
          de Graeff PA
          Haaijer-Ruskamp FM
        affil: Department of Clinical Pharmacology, University of Groningen, The Netherlands.
      sug:
        subj:
          Angiotensin-Converting Enzyme Inhibitors Therapeutic Use
          Antihypertensive Agents Therapeutic Use
          Diabetes Mellitus, Type 2 Complications
          Education, Medical, Continuing
          Family Practice Education
          Heart Failure Drug Therapy
          Hypertension Drug Therapy
          Peer Review
          Professional Compliance Evaluation
          Chronic Disease
          Clinical Trials
          Cluster Analysis
          Descriptive Statistics
          Female
          Funding Source
          Hypertension Etiology
          Linear Regression
          Logistic Regression
          Male
          Netherlands
          Outcome Assessment
          Physician Attitudes
          Practice Guidelines Education
          Program Evaluation
          Questionnaires
          Random Assignment
          Regression
          Student Attitudes
          Human
          Female
          Male
      ab: Rationale, aims and objectives Peer review groups are considered helpful for quality improvement in primary care. An interactive educational programme for small peer groups was developed, focusing on the implementation of newly developed treatment guidelines. The aim is to evaluate the effect of the programme on adherence to treatment guidelines in general practice. Methods A cluster randomized trial using a balanced incomplete block design was used; one arm received a programme on treatment of chronic heart failure (CHF), the other on hypertension treatment in diabetes mellitus type 2 (T2DM). A random sample of 10 CHF and 10 T2DM patients per GP was drawn, for whom data were extracted from electronic patient records 1 years before and 6 months after the intervention. The outcomes were prescribing of ACE inhibitors, and antihypertensive treatment in T2DM. The effect was analysed separately for both programmes using multilevel regression models. Results All 27 peer review groups in one region in the Netherlands were randomized, of which 16 participated. No significant effects were observed in the CHF group or in the T2DM group. The opportunity for change was limited, as only 53% of the CHF patients and 60% of the T2DM patients had a contact with their GP between the intervention and follow-up measurement. Conclusion The peer review programme was not successful for changing the treatment of chronic patients, although the programme focused on dealing with barriers perceived by the participants. Not all problems perceived can be solved in a peer group discussion.
      pubtype: Academic Journal
      doctype:
        algorithm
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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