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. 2008 Jun 25:9:39.
doi: 10.1186/1745-6215-9-39.

Inefficacy of different strategies to improve guideline awareness - 5-year follow-up of the hypertension evaluation project (HEP)

Jens Hagemeister  1 , Christian A Schneider, Holger Diedrichs, Diana Mebus, Holger Pfaff, Gernot Wassmer, Hans W Höpp
Affiliations

Inefficacy of different strategies to improve guideline awareness - 5-year follow-up of the hypertension evaluation project (HEP)

Jens Hagemeister et al. Trials. .

Abstract

Background: In spite of numerous guidelines for evidence based diagnostic and therapy adequate knowledge of current recommendations is disappointingly low. In the Hypertension Evaluation Project (HEP I) we showed that awareness of national hypertension guidelines under German practitioners was less than 25% in the year 2000. This indicates the need for efficient strategies to relevantly improve guideline awareness.

Methods: To asses different tools for amending guideline knowledge we used three strategies (guideline in print, interactive guideline, expert seminars) to train 8325 randomised physicians, who had participated in the HEP I trial. Guideline knowledge of the trained physicians was again tested with the HEP questionnaire and compared to a control group of HEP I physicians.

Results: The return rate of questionnaires was 57.9% without a significant distinction between the groups. Overall guideline awareness was still low but remarkably improved compared to the results of HEP I (37.1% vs. 23.7%, p < 0.0001). There was no difference between the trained physicians and the control group (35.8% and 35.9% vs. 39.7%, p = n.s.).

Conclusion: We investigated the influence of different strategies to improve guideline awareness among German physicians. None of our interventions (guideline in print, interactive guideline, expert seminars) brought a notable benefit compared to control group. However, overall knowledge of guideline contents increased from 23.7% to 37.1% over five years. Therefore, other probably multimodal interventions are necessary to significantly improve guideline awareness beyond spontaneous advancement.

Trial registration: ISRCTN53383289.

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Figures

Figure 1
Figure 1
Guideline awareness in relation to intervention groups (n = 2474).
Figure 2
Figure 2
Guideline awareness in relation to intervention groups and professional specification (P = n.s.).
Figure 3
Figure 3
Guideline awareness in relation to professional specification in 2000 (n = 11547) and 2005 (n = 2474) for the total sample. * P < 0.0001 for comparison of 2000 and 2005.
Figure 4
Figure 4
Guideline awareness in relation to duration of private practice in 2000 (n = 11547) und 2005 (n = 2474). * P < 0.0001 for comparison of 2000 and 2005.
See this image and copyright information in PMC

References

    1. Ollenschläger G, Marshall C, Qureshi S, Rosenbrand K, Burgers J, Mäkelä M, Slutsky J, Board of Trustees 2002, Guidelines International Network (G-I-N) Improving the quality of health care: using international collaboration to inform guideline programmes by founding the Guidelines International Network (G-I-N) Qual Saf Health Care. 2004;13:455–460. doi: 10.1136/qshc.2003.009761. - DOI - PMC - PubMed
    1. Hagemeister J, Schneider CA, Barabas S, Schadt R, Wassmer G, Mager G, Pfaff H, Höpp HW. Hypertension guidelines and their limitations – the impact of physicians' compliance as evaluated by guideline awareness. J Hypertens. 2001;19:2079–2086. doi: 10.1097/00004872-200111000-00020. - DOI - PubMed
    1. Dillman DA. The total design method. In: Dillman DA, editor. Mail and telephone surveys. New York: Wiley; 1978.
    1. Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, Whitty P, Eccles MP, Matowe L, Shirran L, Wensing M, Dijkstra R, Donaldson C. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess. 2004;8:1–72. - PubMed
    1. Gross PA, Greenfield S, Cretin S, Ferguson J, Grimshaw J, Grol R, Klazinga N, Lorenz W, Meyer GS, Riccobono C, Schoenbaum SC, Schyve P, Shaw C. Optimal methods for guideline implementation: conclusions from Leeds Castle meeting. Med Care. 2001;39:85–92. - PubMed

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