Changing physician prescribing patterns through problem-based learning: An interactive, teleconference case-based education program and review of problem-based learning

Division of Allergy and Pulmonary Medicine, St. Louis Children's Hospital, Washington University Medical School, St. Louis, Missouri, USA.
Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology (Impact Factor: 2.6). 10/2004; 93(3):237-42. DOI: 10.1016/S1081-1206(10)61494-9
Source: PubMed


Although asthma guidelines have recommended the use of anti-inflammatory controller medications since 1991, studies have consistently shown widespread failure to follow the guidelines. Major barriers include lack of knowledge and the inability to operationalize knowledge. Improved continuing medical education methods should result in more effective learning by physicians and other health care professionals, leading to better adherence to guidelines, resulting in better outcomes.
To evaluate the effectiveness of an interactive, case-based, educational intervention, also known as problem-based learning, using a series of interactive, case-based teleconferences.
A series of interactive, case-based teleconferences was completed with 20 primary care physicians. Each case involved a child aged 16 months to 12 years with asthma. A 12-month analysis of physician prescribing patterns was conducted.
Program acceptance by the 20 physicians was uniformly positive. Significant improvement was noted, with an overall increase in controller use. Review of prescription data showed an increase in inhaled corticosteroid use from an average of 2.54 to 7.76 refills per month for the 6 months after the intervention (P < .001).
After participating in a unique educational intervention-problem-based learning using interactive, case-based teleconferences-the prescribing patterns of physicians were altered significantly toward better adherence to asthma guidelines, as demonstrated by an increased use of anti-inflammatory controller medications (inhaled corticosteroids and leukotriene antagonists).

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    • "Producer-independent information on drugs can be provided in different ways. Oral information combined with reminding notes has been shown to influence prescription patterns [2] as well as interactive teleconference [3]. Cochrane reviews indicate that audit and feedback [4] as well as interactive workshops [5] and educational outreach visits [6] can be effective in improving professional practice. "
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    ABSTRACT: To provide doctors with producer-independent information to facilitate choice of treatment is an important task. The objective of the present study was to evaluate if an e-mail with a drug information attachment has effects on sales of prescribed drugs and if the design of the attachment is of importance. The Swedish pharmaceutical benefit board found rizatriptan (Maxalt) 10 mg to be the most cost-effective triptan. All 119 heads of primary care units in western Sweden were randomized to receive information concerning this conclusion via (i) e-mail with attachment I, (ii) e-mail with attachment II or (iii) no information (control). Attachment I was a short one (heading plus three lines text), whereas attachment II was a long one (heading plus one page text and one page with tables). The change in percentage rizatriptan of total triptans sold before and after the intervention (May - July 2004 and May - July 2005, respectively) was compared between the groups. Totally 48,229 (2004) and 50,674 (2005) defined daily doses of triptans were prescribed and sold during May - July in primary care units in the western part of Sweden. The absolute change in percentage rizatriptan was greater in the intervention groups compared with the control group 2 (25th - 75th percentile: -3 - 7) vs 0 (-7 - 5), P = 0.031). The absolute change in percentage rizatriptan did not differ between the two attachment groups (P = 0.93). An e-mail with a drug information attachment may influence sales of prescribed drugs. No difference between different designs of the attachment could be detected.
    BMC Clinical Pharmacology 02/2007; 7(1):12. DOI:10.1186/1472-6904-7-12 · 1.36 Impact Factor

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