Studies
Impact of a General Practitioner Educational Intervention on Osteoarthritis Treatment in an Elderly Population
Author: Rahme E, Choquette D, Beaulieu M, Bessette L, Joseph L, Toubouti Y, LeLorier J
Intervention Type: Distribution of Educational Materials to Professionals, Educational Meetings for Professionals
Disease State: Osteoarthritis/Osteoporosis
Research Objective
To assess whether an interactive teaching intervention complemented by a decision algorithm has an effect on general practitioner’s prescriptions of medications (NSAIDs, COX-2 inhibitors, acetaminophen) for elderly patients suffering from osteoarthritis”
Methods
Design: Randomized controlled trial that was 135 days in duration
Study sample: General practitioners
Intervention:
Group 1 – Intervention 1: workshop plus decision tree: 90-minute workshop discussing evidence-based management of patient with osteoarthritis, peer-facilitated by general practitioner with rheumatologist as resource personnel; decision-tree hand-out discussing treatment choices for patients with osteoarthritis
Group 2 – Intervention 2: workshop only
Group 3 – Intervention 3: decision tree only, with letter regarding content and use
Group 4 - Control: Usual care
Medication Prescribing and Use Outcome(s)
- Number of osteoarthritis prescriptions scored as adequate by study personnel according to set algorithm for osteoarthritis treatment designed by study team (Adequate was: 1) all acetaminophen use, 2) NSAIDs/ COX-2s plus or minus a GI protective agent according to GI risk and 3) use of acetaminophen prior to NSAIDS/COX-2s)
Key Results
- Trend toward greater improvement in NSAIDs and COX-2 inhibitors scored as adequate in the active intervention (workshops) groups over the control and decision tree groups (not significant)
- Trend toward increase in the number of acetaminophen prescriptions in the active intervention (workshops) groups over the control and decision tree groups (not significant)
- by severe weather
- Some evidence that physician practice size is negatively associated with benefit from intervention and that more recent graduation is positively associated with benefit from intervention (not significant)
Key Implementation Issues
- Workshop modeled after Script Concordance test and approved for educational credit, but attendance limited
Citation(s)
Impact of a general practitioner educational intervention on osteoarthritis treatment in an elderly population. Rahme, E., Choquette, D., Beaulieu, M., Bessette, L., Joseph, L., Toubouti, Y. &, LeLorier, J. (2005). The American Journal of Medicine, 118, 1262-1270.