Ontario Printed Educational Materials (PEMs) for Physician Behaviour Change
NCT ID: NCT00210275
Last Updated: 2015-03-26
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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UNKNOWN
NA
5000 participants
INTERVENTIONAL
2005-07-31
2016-07-31
Brief Summary
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Detailed Description
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There are gaps between what family practitioners do in clinical practice and the evidence-based ideal. The most commonly used strategy to narrow these gaps is the printed educational message (PEM); however, the attributes of successful printed educational messages and their overall effectiveness in changing physician practice are not clear. The current endeavor aims to determine whether such messages change prescribing quality in primary care practice, and whether these effects differ with the format of the message.
METHODS/DESIGN:
The design is a large, simple, factorial, unblinded cluster-randomized controlled trial. PEMs will be distributed with informed, a quarterly evidence-based synopsis of current clinical information produced by the Institute for Clinical Evaluative Sciences, Toronto, Canada, and will be sent to all eligible general and family practitioners in Ontario. There will be three replicates of the trial, with three different educational messages, each aimed at narrowing a specific evidence-practice gap as follows: 1) angiotensin-converting enzyme inhibitors, hypertension treatment, and cholesterol lowering agents for diabetes; 2) retinal screening for diabetes; and 3) diuretics for hypertension.For each of the three replicates there will be three intervention groups. The first group will receive informed with an attached postcard-sized, short, directive "outsert." The second intervention group will receive informed with a two-page explanatory "insert" on the same topic. The third intervention group will receive informed, with both the above-mentioned outsert and insert. The control group will receive informed only, without either an outsert or insert.Routinely collected physician billing, prescription, and hospital data found in Ontario's administrative databases will be used to monitor pre-defined prescribing changes relevant and specific to each replicate, following delivery of the educational messages. Multi-level modeling will be used to study patterns in physician-prescribing quality over four quarters, before and after each of the three interventions. Subgroup analyses will be performed to assess the association between the characteristics of the physician's place of practice and target behaviours.A further analysis of the immediate and delayed impacts of the PEMs will be performed using time-series analysis and interventional, auto-regressive, integrated moving average modeling.
Conditions
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Study Design
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RANDOMIZED
FACTORIAL
HEALTH_SERVICES_RESEARCH
NONE
Study Groups
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Control
Usual practice; no additional information provided.
No interventions assigned to this group
Printed Educational Message #1
Information about Angiotensin-converting enzyme inhibitors, hypertension treatment, and cholesterol lowering agents for diabetes
Printed Educational Message
Three forms of printed educational materials (short or long educational messages and patient reminder notes)
Printed Educational Message #2
Retinal screening for diabetes
Printed Educational Message
Three forms of printed educational materials (short or long educational messages and patient reminder notes)
Printed Educational Message #3
Diuretics for hypertension
Printed Educational Message
Three forms of printed educational materials (short or long educational messages and patient reminder notes)
Interventions
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Printed Educational Message
Three forms of printed educational materials (short or long educational messages and patient reminder notes)
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
ALL
No
Sponsors
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Institute for Clinical Evaluative Sciences
OTHER
Responsible Party
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Merrick Zwarenstein
Senior Scientist
Principal Investigators
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Merrick F. Zwarenstein, MB, BCh, MSc
Role: PRINCIPAL_INVESTIGATOR
Institute for Clinical Evaluative Sciences
Other Identifiers
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MCT-67916
Identifier Type: -
Identifier Source: org_study_id
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