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Meta-Analysis
. 2007 Oct 17;2007(4):CD000409.
doi: 10.1002/14651858.CD000409.pub2.

Educational outreach visits: effects on professional practice and health care outcomes

M A O'Brien  1 , S Rogers, G Jamtvedt, A D Oxman, J Odgaard-Jensen, D T Kristoffersen, L Forsetlund, D Bainbridge, N Freemantle, D A Davis, R B Haynes, E L Harvey
Affiliations
Meta-Analysis

Educational outreach visits: effects on professional practice and health care outcomes

M A O'Brien et al. Cochrane Database Syst Rev. .

Abstract

Background: Educational outreach visits (EOVs) have been identified as an intervention that may improve the practice of healthcare professionals. This type of face-to-face visit has been referred to as university-based educational detailing, academic detailing, and educational visiting.

Objectives: To assess the effects of EOVs on health professional practice or patient outcomes.

Search strategy: For this update, we searched the Cochrane EPOC register to March 2007. In the original review, we searched multiple bibliographic databases including MEDLINE and CINAHL.

Selection criteria: Randomised trials of EOVs that reported an objective measure of professional performance or healthcare outcomes. An EOV was defined as a personal visit by a trained person to healthcare professionals in their own settings.

Data collection and analysis: Two reviewers independently extracted data and assessed study quality. We used bubble plots and box plots to visually inspect the data. We conducted both quantitative and qualitative analyses. We used meta-regression to examine potential sources of heterogeneity determined a priori. We hypothesised eight factors to explain variation across effect estimates. In our primary visual and statistical analyses, we included only studies with dichotomous outcomes, with baseline data and with low or moderate risk of bias, in which the intervention included an EOV and was compared to no intervention.

Main results: We included 69 studies involving more than 15,000 health professionals. Twenty-eight studies (34 comparisons) contributed to the calculation of the median and interquartile range for the main comparison. The median adjusted risk difference (RD) in compliance with desired practice was 5.6% (interquartile range 3.0% to 9.0%). The adjusted RDs were highly consistent for prescribing (median 4.8%, interquartile range 3.0% to 6.5% for 17 comparisons), but varied for other types of professional performance (median 6.0%, interquartile range 3.6% to 16.0% for 17 comparisons). Meta-regression was limited by the large number of potential explanatory factors (eight) with only 31 comparisons, and did not provide any compelling explanations for the observed variation in adjusted RDs. There were 18 comparisons with continuous outcomes, with a median adjusted relative improvement of 21% (interquartile range 11% to 41%). There were eight trials (12 comparisons) in which the intervention included an EOV and was compared to another type of intervention, usually audit and feedback. Interventions that included EOVs appeared to be slightly superior to audit and feedback. Only six studies evaluated different types of visits in head-to-head comparisons. When individual visits were compared to group visits (three trials), the results were mixed.

Authors' conclusions: EOVs alone or when combined with other interventions have effects on prescribing that are relatively consistent and small, but potentially important. Their effects on other types of professional performance vary from small to modest improvements, and it is not possible from this review to explain that variation.

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Conflict of interest statement

None known.

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References

References to studies included in this review

Avorn 1983 {published data only}
    1. Avorn J, Soumerai SB. Improving drug‐therapy decisions through educational outreach. A randomized controlled trial of academically based "detailing". New England Journal of Medicine 1983;308:1457‐63. - PubMed
Avorn 1992 {published data only}
    1. Avorn J, Soumerai SB, Everitt DE, Ross‐Degnan D, Beers MH, Sherman D, et al. A randomized trial of a program to reduce the use of psychoactive drugs in nursing homes. New England Journal of Medicine 1992;327:168‐73. - PubMed
Berings 1994 {published data only}
    1. Berings D, Blondeel L, Habraken H. The effect of industry‐independent drug information on the prescribing of benzodiazepines in general practice. European Journal of Clinical Pharmacology 1994;46:501‐5. - PubMed
Borgiel 1999 {published data only}
    1. Borgiel AE, Williams J.I, Davis DA, Dunn EV, Hobbs N, Hutchison B, et al. Evaluating the effectiveness of 2 educational interventions in family practice. CMAJ 1999;161(8):965‐70. - PMC - PubMed
Braybrook 1996 {published data only}
    1. Braybrook S, Walker R. Influencing NSAID prescribing in primary care using different feedback strategies. Pharmacy World & Science 2000;22(2):39‐46. - PubMed
    1. Braybrook S, Walker R. Influencing prescribing in primary care: a comparison of two different prescribing feedback methods. Journal of Clinical Pharmacy and Therapeutics 1996;21:247‐54. - PubMed
Brown 1994 {published data only}
    1. Brown LF, Keily PA, Spencer AJ. Evaluation of a continuing education intervention "Periodontics in General Practice". Community Dentistry and Oral Epidemiology 1994;22:441‐7. - PubMed
Cheater 2006 {published data only}
    1. Cheater FM, Baker R, Reddish S, Spiers N, Wailoo A, Gillies C, et al. Cluster randomized controlled trial of the effectiveness of audit and feedback and educational outreach on improving nursing practice and patient outcomes. Medical Care 2006;44(6):542‐51. - PubMed
Cockburn 1992 {published data only}
    1. Cockburn J, Ruth D, Silagy C, Dobbin M, Reid Y, Scollo M, et al. Randomised trial of three approaches for marketing smoking cessation programmes to Australian general practitioners. BMJ 1992;304:691‐4. - PMC - PubMed
Coenen 2004 {published data only}
    1. Coenen S, Royen P, Michiels B, Denekens J. Optimizing antibiotic prescribing for acute cough in general practice: a cluster randomized controlled trial. Journal of Antimicrobial Chemotherapy 2004;54:661‐72. - PubMed
Crotty 2004 {published data only}
    1. Crotty M, Whitehead C, Rowett D, Halbert J, Weller D, Finucane P, et al. An outreach intervention to implement evidence based practice in residential care: a randomized controlled trial [ISRCTN67855475]. BMC Health Services Research 2004;4(1):6. - PMC - PubMed
de Burgh 1995 {published data only}
    1. Mant A, Burgh S, Mattick RP, Donnelly N, Hall W. Insomnia in general practice. Results from NSW general practice survey. Australian family physician 1996;Suppl 1:S15‐S18. - PubMed
    1. Yeo GT, Burgh SP, Letton T, Shaw J, Donnelly N, Swinburn ME, et al. Educational visiting and hypnosedative prescribing in general practice. Family Practice 1994;11:57‐61. - PubMed
    1. Burgh S, Mant A, Mattick RP, Donnelly N, Hall W, Bridges‐Webb C. A controlled trial of educational visiting to improve benzodiazepine prescribing in general practice. Australian Journal of Public Health 1995;19:142‐8. - PubMed
Dey 2004 {published data only}
    1. Dey P, Simpson CWR, Collins SI, Hodgson G, Dowrick CF, Siminson AJM, et al. Implementation of RCGP guidelines for acute low back pain: a cluster randomized controlled trial. British Journal of General Practice 2004;54:33‐7. - PMC - PubMed
Diwan 1995 {published data only}
    1. Diwan VK, Wahlstrom R, Tomson G, Beermann B, Sterky G, Eriksson B. Effects of "group detailing" on the prescribing of lipid‐lowering drugs: a randomized controlled trial in Swedish primary care. Journal of Clinical Epidemiology 1995;48:705‐11. - PubMed
Feder 1995 {published data only}
    1. Feder G, Griffiths C, Highton C, Eldridge S, Spence M, Southgate L. Do clinical guidelines introduced with practice based education improve care of asthmatic and diabetic patients? A randomised controlled trial in general practices in east London. BMJ 1995;311:1473‐8. - PMC - PubMed
Fender 1999 {published data only}
    1. Fender GRK, Prentice A, Gorst T, Nixon RM, Duffy SW, Day NE, et al. Randomised controlled trial of educational package on management of menorrhagia in primary care: the Anglia menorrhagia education study. BMJ 1999;318:1246‐50. - PMC - PubMed
Figueiras 2001 {published data only}
    1. Figueiras A, Sastre I, Tato F, Rodriguez C, Lado E, Caamano F, et al. One‐to‐one versus group sessions to improve prescription in primary care; a pragmatic randomized controlled trial. Medical Care 2001;39(2):158‐67. - PubMed
Figueiras 2006 {published data only}
    1. Figueiras A, Herdeiro MT, Polonia J, Gestal‐Otero JJ. An educational intervention to improve physician reporting of adverse drug reactions: a cluster randomized controlled trial. JAMA 2006;296:1086‐93. - PubMed
Finkelstein 2001 {published data only}
    1. Finkelstein JA, Davis RL, Dowell SF, Metlay JP, Soumerai SB, Rifas‐Shiman Sl, et al. Reducing antibiotic use in children: a randomized trial in 12 practices. Pediatrics 2001;108:1‐7. - PubMed
Font 1991 {published data only}
    1. Font M, Madridejos R, Catalán A, Jiménez J, Argimón JM, Huguet M. Improving drug prescription in primary care: a controlled and randomized study of an educational method [Mejorar la prescripción de fármacos en atención primaria : un estudio controlado y aleatorio sobre un método educativo]. Medicina clínica 1991;96(6):201‐5. - PubMed
Freemantle 2000 {published data only}
    1. Freemantle N, Johnson R, Dennis J, Kennedy A, Marchment M. Sleeping with the enemy? A randomized controlled trial of a collaborative health authority/industry intervention to influence prescribing practice. British Journal of Clinical Pharmacology 2000;49:174‐9. - PMC - PubMed
Freemantle 2002 {published data only}
    1. Freemantle N, Eccles M, Wood J, Mason J, Nazareth I, Duggan C, et al. A randomized trial of evidence‐based outreach (EBOR): rationale and design. Controlled Clinical Trials 1999;20:479‐92. - PubMed
    1. Freemantle N, Nazareth I, Eccles M, Wood J, Haines A, EBOR trialists. A randomized controlled trial of the effect of educational outreach by community pharmacists on prescribing in UK general practice. British Journal of General Practice 2002;52:290‐5. - PMC - PubMed
Fretheim 2006 {published data only}
    1. Fretheim A, Aaserud M, Oxman AD. Rational Prescribing in Primary Care (RaPP): Economic evaluation of an intervention to improve professional practice. PLoS Med 2006;3(6):e216. DOI: 10.1371/journal.pmed.0030216. - PMC - PubMed
    1. Fretheim A, Oxman AD, Havelsrud K, Treweek S, Kristoffersen DT, Bjorndal A. Rational Prescribing in Primary Care (RaPP): A cluster randomized trial of a tailored intervention. PLoS Medicine/Public Library of Science 2006;3(6):e134. DOI: 10.1371/journal.pmed.0030134. - PMC - PubMed
Frijling 2003 {published data only}
    1. Frijling BD, Lobo CM, Hulscher MEJ, Akkermans RP, Drenth BB, Prins A, et al. Intensive support to improve clinical decision making in cardiovascular care: a randomised controlled trial in general practice. Quality & Safety in Health Care 2003;12(3):181‐7. - PMC - PubMed
Griffiths 2004 {published data only}
    1. Griffiths C, Foster G, Barnes N, Eldridge S, Tate H, Begum S, et al. Specialist nurse intervention to reduce unscheduled asthma care in a deprived multiethnic area: the east London randomized controlled trial for high risk asthma (ELECTRA). BMJ 2004;328:144‐. - PMC - PubMed
Hall 2001 {published data only}
    1. Hall L, Eccles M, Barton R, Steen N, Campbell M. In untargeted outreach visiting in primary care effective? A pragmatic randomized controlled trial. Journal of Public Health Medicine 2001;23(2):109‐13. - PubMed
Hendryx 1998 {published data only}
    1. Hendryx MS, Fieselmann JF, Bock MJ, Wakefield DS, Helms CM, Bentler SE. Outreach Education to Improve Quality of Rural ICU Care. American Journal of Respiratory and Critical Care Medicine 1998;158:418‐23. - PubMed
Hennessy 2006 {published data only}
    1. Hennessy S, Leonard CE, Yang W, Kimmel SE, Townsend RR, Wasserstein AG, et al. Effectiveness of a two‐part educational intervention to improve hypertension control: a cluster‐randomized trial. Pharmacotherapy 2006;26:1342‐7. - PubMed
Ilett 2000 {published data only}
    1. Ilett KF, Johnson S, Greenhill G, Mullen L, Brockis J, Golledge CL, et al. Modification of general practitioner prescribing of antibiotics by use of a therapeutics adviser (academic detailer). British Journal of Clinical Parmacology 2000;49:168‐73. - PMC - PubMed
Kaner 1999 {published data only}
    1. Kaner EFS, Lock CA, McAvoy B, Heather N, Gilvarry E. A RCT of three training and support strategies to encourage implementation of screening and brief alcohol intervention by general practitioners. British Journal of General Practice 1999;49:699‐703. - PMC - PubMed
Kerse 1999 {published data only}
    1. Kerse NM, Flicker L, Jolley D, Arroll B, Young D. Improving the health behaviours of elderly people: randomised controlled trial of a general practice education programme. BMJ 1999;319(7211):683‐7. - PMC - PubMed
Kim 1999 {published data only}
    1. Kim KS, Kristopaitis RJ, Stone E, Pe, ter M, Sandu M, Weingarten SR. Physician education and report cards: do they make the grade? Results from a randomized controlled trial. American Journal of Medicine 1999;107:556‐60. - PubMed
Lemelin 2001 {published data only}
    1. Lemelin J, Hogg, W, Baskerville N. Evidence to action: a tailored multifaceted approach to changing family physician practice patterns and improving preventive care. Canadian Medical Association Journal 2001;164(6):757‐63. - PMC - PubMed
Loeb 2005 {published data only}
    1. Loeb M, Brazil K, Lohfeld L, McGeer A, Simor A, Stevenson K, et al. Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes: cluster randomised controlled trial. BMJ 2005;331(7518):669‐. - PMC - PubMed
Martin 2004 {published data only}
    1. Martin CM, Doig GS, Heyland DK, Morrison T, Sibbald WJ. Multi‐centre, cluster‐randomized clinical trial of algorithms for critical‐care enteral and parenteral therapy. CMAJ 2004;170:197‐204. - PMC - PubMed
McBride 2000 {published data only}
    1. McBride P, Underbakke G, Plane MB, Massoth K, Brown RL, Solberg LI, et al. Improving prevention systems in primary care practices. Journal of Family Practice 2000;49(2):115‐25. - PubMed
McConnell 1982 {published data only}
    1. McConnell TS, Cushing AH, Bankhurst AD, Healy JL, McIlvenna PA, Skipper BJ. Physician behavior modification using claims data: tetracycline for upper respiratory infection. The Western Journal of Medicine 1982;137:448‐50. - PMC - PubMed
Modell 1998 {published data only}
    1. Modell M, Wonke B, Anionwu E, Khan M, See Tai S, Lloyd M, et al. A multidisciplinary approach for improving service in primary care: randomised controlled trial of screening for haemoglobin disorders. BMJ 1998;317:788‐91. - PMC - PubMed
Myers 2004 {published data only}
    1. Myers RE, Turner B, Weinberg D, Hyslop T, Hauk WW, Brigham T, et al. Impact of a physician‐oriented intervetnion on follow‐up in colorectal cancer screening. Preventive Medicine 2004;38:375‐81. - PubMed
New 2004 {published data only}
    1. New JP, Mason JM, Freemantle N, Teasdate S, Wong L, Bruce NJ, et al. Educational outreach in diabetes to encourage practice nurses to use primary care hypertension and hyperlipidaemia guidelines (EDEN): a randomized controlled trial. Diabetic Medicine 2004;21:599‐603. - PubMed
Newton‐Syms 1992 {published data only}
    1. Newton‐Syms FA, Dawson PH, Cooke J, Feely M, Booth TG, Jerwood D, et al. The influence of an academic representative on prescribing by general practitioners. British Journal of Clinical Pharmacology 1992;33:69‐73. - PMC - PubMed
Ofman 2003 {published data only}
    1. Ofman JJ, Segal R, Russell WL, Cook DJ, Sandhu M, Maue SK, et al. A randomized trial of an acid‐peptic disease managment program in a managed care environment. The American Journal of Managed care 2003;9:425‐33. - PubMed
Ornstein 2004 {published data only}
    1. Ornstein S, Jenkins R, Nietert PJ, Feifer C, Roylance LR, Nemeth L, et al. A multimethod quality improvement intervention to improve preventive cardiovascular care. Annals of Internal Medicine 2004;141:523‐32. - PubMed
Pagaiya 2005 {published data only}
    1. Pagaiya N, Garner P. Primary care nurse using guidelines in Thailand: a randomized controlled trial. Tropical Medicine and International Health 2005;10:471‐7. - PubMed
Pill 1998 {published data only}
    1. Pill R, Stott NCH, Rollnick SR, Rees M. A randomized controlled trial of an intervention designed to improve the care given in general practice to Type II diabetic patients: patient outcomes and professional ability to change behaviour. Family Practice 1998;15(3):229‐35. - PubMed
Premaratne 1999 {published data only}
    1. Premaratne UN, Sterne JAC, Marks GB, Webb JR, Azima H, Burney PGJ. Clustered randomized trial of an intervention to improve the management of asthma: Greenwich asthma study. BMJ 1999;318(8 May):1251‐5. - PMC - PubMed
Putnam 1985 {published data only}
    1. Putnam RW, Curry L. Impact of patient care appraisal on physician behaviour in the office setting. CMAJ 1985;132:1025‐9. - PMC - PubMed
Rabin 1994 {published data only}
    1. Rabin DL, Boekeloo BO, Marx ES, Bowman MA, Russell NK, Willis AG. Improving office‐based physicians' prevention practices for sexually transmitted diseases. Annals of Internal Medicine 1994;121:513‐9. - PubMed
Raisch 1990 {published data only}
    1. Raisch DW, Bootman JL, Larson LN, McGhan WF. Improving antiulcer agent prescribing in a health maintenance organization. American Journal of Hospital Pharmacy 1990;47:1766‐73. - PubMed
Ross‐Degnan 1996b {published data only}
    1. Ross‐Degnan D, Soumerai SB, Goel PK, Bates J, Makhulo J, Dondi N, et al. The impact of face‐to‐face educational outreach on diarrhoea treatment in pharmacies. Health Policy and Planning 1996;11(3):308‐18. - PubMed
Santoso 1996 {published data only}
    1. Santoso B, Suryawti S, Prawaitasari JE. Small group intervention vs formal seminar for improving appropriate drug use. Social Science and Medicine 1996;42(8):1163‐8. - PubMed
Schmidt 1998 {published data only}
    1. Schmidt I, Claesson CB, Westerholm B, Nilsson LG, Svarstad BL. The impact of regular multidisciplinary team interventions on psychotropic prescribing in Swedish nursing homes. Journal of the American Geriatric Society 1998;46:77‐82. - PubMed
SimkinSilverman 1997 {published data only}
    1. Simkin‐Silverman LR, Wing RR. Management of obesity in primary care. Obesity Research 1997;5(6):603‐12. - PubMed
Simon 2005 {published data only}
    1. Simon S, Majumdar SR, Prosser LA, Salem‐Schatz S, Warner C, Kleinman K, et al. Group versus individual academic detailing to improve the use of antihypertensive medications in primary care: a cluster randomized controlled trial. The American Journal of Medicine 2005;118:521‐8. - PubMed
Siriwardena 2002 {published data only}
    1. Siriwardena AN, Rashid A, Johnson MR, Dewey ME. Cluster randomised controlled trial of an educational outreach visit to improve influenza and pneumococcal immunisation rates in primary care. The British Journal of General Practice : the journal of the Royal College of General Practitioners 2002;52(482):735‐40. - PMC - PubMed
Solomon 2001 {published data only}
    1. Solomon DH, Houten L, Glynn RJ, Baden L, Curtis K, Schrager H, et al. Academic detailing to improve use of broad‐spectrum antibiotics at an academic medical center. Archives of Internal Medicine 2001;161:1897‐902. - PubMed
Soumerai 1993 {published data only}
    1. Soumerai SB, Salem‐Schatz S, Avorn J, Casteris CS, Ross‐Degnan D, Popovsky MA. A controlled trial of educational outreach to improve blood transfusion practice. JAMA 1993;270:961‐6. - PubMed
Steele 1989 {published data only}
    1. Steele MA, Bess DT, Franse VL, Graber SE. Cost effectiveness of two interventions for reducing outpatient prescribing costs. DICP 1989;23:497‐500. - PubMed
Taylor 1999 {published data only}
    1. Taylor V, Thompson B, Lessler D, Yasui Y, Montano D, Johnson KM, et al. A clinic‐based mammography intervention targeting inner‐city women. Journal of General Internal Medicine 1999;14:104‐11. - PubMed
van der Weijden 1999 {published data only}
    1. Weijden T, Grol RP, Knottnerus JA. Feasibility of a national cholesterol guideline in daily practice. A randomized controlled trial in 20 general practices. International Journal for Quality in Health Care 1999;11(1):131‐7. - PubMed
van Eijk 2001 {published data only}
    1. Eijk MEC, Avorn J, Porsius AJ, Boer A. Reducing prescribing of highly anticholinergic antidepressants for elderly people: randomised trial of group vs individual academic detailing. BMJ 2001;322:1‐6. - PMC - PubMed
vanden Hombergh 1999 {published data only}
    1. Hombergh P, Grol R, Hoogen HJ, Bosch WJ. Practice visits as a tool in quality improvement: mutual visits and feedback by peers compared with visits and feedback by non‐physician observers. Quality in Health Care 1999;8(3):161‐6. - PMC - PubMed
Walsh 2005 {published data only}
    1. Walsh JME, Salazar R, Terdiman JP, Gildengorin G, Perez‐Stable EJ. Promoting the use of colorectal cancer screening tests. Journal of General Internal medicine 2005;20:1097‐101. - PMC - PubMed
Watson 2001 {published data only}
    1. Watson M, Gunnell D, Peters T, Brookes S, Sharp D. Guidelines and educational outreach visits from community pharmacists to improve prescribing in general practice; a randomized controlled trial. Journal of Health Services Research & Policy 2001;6(4):207‐13. - PubMed
Watson 2002 {published data only}
    1. Watson MC, Bond CM, Grimshaw JM, Mollison J, Ludbrook A, Walker AE. Educational strategies to promote evidence‐based community pharmacy practice: a cluster randomized controlled trial (RCT). Family Practice 2002;19(5):529‐36. - PubMed
Weller 2003 {published data only}
    1. Weller D, May F, Rowett D, Esterman A, Pinnock C, Nicholson S, et al. Promoting better use of the PSA test in general practice: randomized controlled trial of educational strategies based on outreach visits and mailout. Family Practice 2003;20(6):655‐61. - PubMed
Witt 2004 {published data only}
    1. Witt K, Knudson E, Ditlevsen S, Hollnagel H. Academic detailing has no effect on prescribing of asthma medication in Danish general practice: a 3‐year randomized controlled trial with 12‐monthly follow‐ups. Family Practice 2004;21(3):248‐53. - PubMed
Wyatt 1998 {published data only}
    1. Wyatt JC, Paterson‐Brown S, Johanson R, Altman DG, Bradburn MJ. Randomised trial of educational visits to enhance use of systematic reviews in 25 obstetric units. BMJ 1998;317:1041‐6. - PMC - PubMed
Young 2002 {published data only}
    1. Young JM, D'Este C, Ward JE. Improving family physicians' use of evidence‐based smoking cessation strategies: a cluster randomization trial. Preventative Medicine 2002;35(6):572‐83. - PubMed
    1. Young JM, Ward JE. Randomised trial of intensive academic detailing to promote opportunistic recruitment of women to cervical screening by general practitioners. Australian and New Zealand Journal of Public Health 2003;27(3):273‐81. - PubMed
Zwar 2000 {published data only}
    1. Zwar NA, Wolk J, Gordon J, Sanson‐Fisher RW. Benzodiazepine prescribing by GP registrars; A trial of educational research. Australian Family Physician 2000;29(11):1104‐7. - PubMed

References to studies excluded from this review

Baker 2001 {published data only}
    1. Baker R, Reddish S, Robertson N, Hearnshaw H, Jones B. Randomized controlled trial of tailored strategies to implement guidelines for the management of patients with depression in general practice. British Journal of General Practice 2001;51:737‐41. - PMC - PubMed
Betz‐Brown 2000 {published data only}
    1. Betz Brown J, Shye D, Bentson D, McFarland BH, Nichols GA, Mullooly JP, Johnson RE. Controlled trials of CQI and academic detailing to implement a clinical practice guideline for depression. Journal on Quality Improvement 2000;26(1):39‐54. - PubMed
Dietrich 1992 {published data only}
    1. Dietrich AJ, O'Connor GT, Keller A, Carney PA, Levy D, Whaley FS. Cancer: improving early detection and prevention. A community practice randomised trial. BMJ 1992;304:687‐91. - PMC - PubMed
Dolovich 1999 {published data only}
    1. Dolovich L, Levine M, Tarajos R, Duku E. Promoting optimal antibiotic therapy for otitis media using commercially sponsored evidence‐based detailing: A prospective controlled trial. Drug Information Journal 1999;33:1067‐77.
Hampshire 1999 {published data only}
    1. Hampshire A, Blair M, Crown N, Avery A, Williams I. Action Research: a useful method of promoting change in primary care?. Family Practice 1999;16(3):305‐11. - PubMed
Joseph 2004 {published data only}
    1. Joseph AM, Arikian NJ, An LC, Nugent SM, Sloan RJ, Pieper CF. Results of a randomized controlled trial of intervention to implement smoking guidelines in veterans affairs medical centres. Medical Care 2004;42:1100‐10. - PubMed
Katzelnick 2000 {published data only}
    1. Katzelnick DJ, Simon GE, Pearson SD, Manning WG, Helstad CP, Henk HJ, et al. Randomized trial of a depression management program in high utilizers of medical care. Archives of Family Medicine 2000;9:345‐51. - PubMed
O'Halloran 2004 {published data only}
    1. O'Halloran PD, Cran GW, Beringer TRO, Kernohan G, O'Neill C, Orr J, et al. A cluster randomised trial to evaluate a policy of making hip protectors available to residents of nursing homes. Age and Aging 2004;33:582‐8. - PubMed
Ray 1985 {published data only}
    1. Ray WA, Schaffner W, Federspiel CF. Persistence of improvement in antibiotic prescribing in office practice. JAMA 1985;253:1774‐6. - PubMed
Ray 1986 {published data only}
    1. Ray WA, Blazer DG 2nd, Schaffner W, Federspiel CF, Fink R. Reducing long‐term diazepam prescribing in office practice. A controlled trial of educational visits. JAMA 1986;256:2536‐9. - PubMed
Ray 1987 {published data only}
    1. Ray WA, Blazer DG 2nd, Schaffner W, Federspiel CF. Reducing antipsychotic drug prescribing for nursing home patients: a controlled trial of the effect of an educational visit. American Journal of Public Health 1987;77:1448‐50. - PMC - PubMed
Ray 1993 {published data only}
    1. Ray WA, Taylor JA, Meador KG, Lichtenstein MJ, Griffin MR, Fought R, et al. Reducing antipsychotic drug use in nursing homes. A controlled trial of provider education. Archives of Internal Medicine 1993;153:713‐21. - PubMed
Ross‐Degnan 1996a {published data only}
    1. Ross‐Degnan D, Soumerai SB, Goel PK, Bates J, Makhulo J, Dondi N, et al. The impact of face‐to‐face educational outreach on diarrhoea treatment in pharmacies. Health Policy and Planning 1996;11:308‐18. - PubMed
Schaffner 1983 {published data only}
    1. Schaffner W, Ray WA, Federspiel CF, Miller WO. Improving antibiotic prescribing in office practice. A controlled trial of three educational methods. JAMA 1983;250:1728‐32. - PubMed
Stergachis 1987 {published data only}
    1. Stergachis A, Fors M, Wagner EH, Sims DD, Penna P. Effect of clinical pharmacists on drug prescribing in a primary‐care clinic. American Journal of Hospital Pharmacy 1987;44:525‐9. - PubMed
Trap 2001 {published data only}
    1. Trap B, Todd, CH, Moore H, Laing R. The impact of supervision on stock management and adherence to treatment guidelines: a randomized controlled trial. Health Policy and Planning 2001;16(3):273‐80. - PubMed

References to studies awaiting assessment

Chalker 2005 {published data only}
    1. Chalker J, Ratanawijitrasin S, Chuc NTK, Petzold M, Tomson G. Effectiveness of a multi‐component intervention on dispensing practices at private pharmacies in Vietnam and Thailand ‐ a randomized controlled trial. Social Science & Medicine 2005;60(1):131‐41. - PubMed
Elliott 1997 {published data only}
    1. Elliott TE, Murray DM, Oken MM, Johnson KM, Braun BL, Elliott BA, et al. Improving cancer pain management in communities: main results from a randomized controlled trial. Journal of Pain & Symptom Management 1997;13(4):191‐203. - PubMed
Funk 2005 {published data only}
    1. Funk M, Wutzke S, Kaner E, Anderson P, Pas L, McCormick R, et al. A multicountry controlled trial of strategies to promote dissemination and implementation of brief alcohol intervention in primary health care: findings of a World Health Organization collaborative study. Journal of Studies on Alcohol 2005;66(3):379‐88. - PubMed
Kinsinger 1998 {published data only}
    1. Kinsinger LS, Harris R, Qaqish B, Strecher V, Kaluzny A. Using an office system intervention to increase breast cancer screening. Journal of General Internal Medicine 1998;13(8):507‐14. - PMC - PubMed
Kottke 2000 {published data only}
    1. Kottke KE, Brekke ML, Magnan S, Davidson G, Calomeni CA, Conn SA, et al. Failure of a continuous quality improvement intervention to increase the delivery of preventive services. A randomized trial. Effective Clinical Practice 2000;3(3):105‐15. - PubMed
Proctor 1999 {published data only}
    1. Proctor R, Burns A, Powell HS, Tarrier N, Faragher B, Richardson G, et al. Behavioural management in nursing and residential homes: a randomised controlled trial. Lancet 1999;354(9172):26‐9. - PubMed
Schoenbaum 2001 {published data only}
    1. Schoenbaum M, Unutzer J, Sherbourne C, Duan N, Rubenstein LV, Miranda J, et al. Cost‐effectiveness of practice‐initiated quality improvement for depression: results of a randomized controlled trial. JAMA 2001;286(11):1325‐30. - PubMed

Additional references

Arnold 2005
    1. Arnold SR, Straus SE. Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD003539. DOI: 10.1002/14651858.CD003539.pub2. - PMC - PubMed
Baskerville 2001
    1. Baskerville NB, Hogg W, Lemelin J. Process evaluation of a tailored multifaceted approach to changing family physician practice patterns improving preventive care. Journal of Family Practice 2001;50(3):242‐9. - PubMed
Doumit 2007
    1. Doumit G, Gattellari M, Grimshaw J, O'Brien MA. Local opinion leaders: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD000125. DOI: 10.1002/14651858.CD000125.pub3. - PubMed
Freemantle 1997
    1. Freemantle N, Harvey EL, Wolf F, Grimshaw JM, Grilli R, Bero LA. Printed educational materials: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 1997, Issue 2. Art. No.: CD000172. DOI: 10.1002/14651858.CD000172. - PMC - PubMed
Green 1988
    1. Green LW, Eriksen MP, Schor EL. Preventive practices by physicians: behavioral determinants and potential interventions. American Journal of Preventative Medicine 1988;4(suppl 4):101‐7. - PubMed
Grimshaw 2003
    1. Grimshaw J, McAuley LM, Bero LA, Grilli R, Oxman AD, Ramsay C, et al. Systematic reviews of the effectiveness of quality improvement strategies and programmes. Quality and Safety in Health Care 2003;12(4):298‐303. - PMC - PubMed
Grimshaw 2004
    1. Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, et al. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technology Assessment 2004;8(6):iii‐iv, 1‐72. - PubMed
Hogg 2005
    1. Hogg W, Baskerville N, Lemelin J. Cost savings associated with improving appropriate and reducing inappropriate preventive care: cost‐consequences analysis. BMC Health Services Research 2005;95(1):20. - PMC - PubMed
Jamtvedt 2006
    1. Jamtvedt G, Young JM, Kristoffersen DT, O'Brien MA, Oxman AD. Audit and feedback: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD000259. DOI: 10.1002/14651858.CD000259.pub2. - PubMed
Mason 2001
    1. Mason J, Freemantle N, Nazareth I, Eccles M, Haines A, Drummond M. When is it cost‐effective to change the behavior of health professionals?. JAMA 2001;286(23):2988‐92. - PubMed
Prochaska 1992
    1. Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviors. The American Psychologist 1992;47:1102‐14. - PubMed
SAS 2003 [Computer program]
    1. SAS Institute Inc., Cary, NC, USA. Statistical Analysis Software (SAS) Version 9.1.. SAS Institute Inc., Cary, NC, USA, 2003.
Soumerai 1986
    1. Soumerai SB, Avorn J. Economic and policy analysis of university‐based drug "detailing". Medical Care 1986;24:313‐31. - PubMed
Soumerai 1989
    1. Soumerai SB, McLaughlin TJ, Avorn J. Improving drug prescribing in primary care: a critical analysis of the experimental literature. Millbank Q 1989;67:268‐317. - PubMed
Soumerai 1990
    1. Soumerai SB, Avorn J. Principles of educational outreach ('academic detailing') to improve clinical decision making. JAMA 1990;263(4):549‐56. - PubMed
Wensing 1994
    1. Wensing M, Grol R. Single and combined strategies for implementing changes in primary care: a literature review. International Journal for Quality in Health Care 1994 June;6(2):115‐32. - PubMed
Wensing 1998
    1. Wensing M, Weijden T, Grol R. Implementing guidelines and innovations in general practice: which interventions are effective?. British Journal of General Practice 1998 Feb;48(427):991‐7. - PMC - PubMed
Young 2003
    1. Young JM, Ward JE. Randomised trial of intensive academic detailing to promote opportunistic recruitment of women to cervical screening by general practitioners. Australian and New Zealand Journal of Public Health 2003;27(3):273‐81. - PubMed

References to other published versions of this review

O'Brien 1997
    1. O'Brien MA, Oxman AD, Davis DA, Haynes RB, Freemantle N, Harvey EL. Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 1997, Issue 4. Art. No.: CD000409. DOI: 10.1002/14651858.CD000409. - PubMed

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