But the education and computer reminder program was no better than the simple guideline at improving other aspects of caring for patients with high blood pressure and/or cholesterol, such as properly assessing patients' risk of heart disease and strokes.
In many countries, including Norway, health authorities want GPs to use an older blood pressure drug called a "thiazide", because it is just as effective as newer drugs and yet it is much cheaper. Unfortunately, many GPs still prescribe the newer medications. The researchers, led by Atle Fretheim (Norwegian Knowledge Centre for Health Services, Oslo), found that 17% of patients whose GPs received the education and computer reminder program were given thiazides, compared with 11% of those whose GPs only received the guideline (a statistically significant difference).
In an accompanying study by the same authors, they found that using the education and computer reminder program was--in the long run--likely to be a good way to save money, given that it led to doctors using a cheaper blood pressure medicine.
Fretheim and colleagues studied 146 general practices in two areas of Norway. Each practice was randomly assigned to receive either the education and computer reminder program or just the guideline. Such a study is known as a randomized controlled trial (the "control group" was the group of practices that just received the guideline).
In an accompanying commentary, Chris Del Mar (Bond University, Australia), who was not involved in the trial, notes that even with the education and computer program, only 17% of patients received the recommended medicine, which, he says, "seems a very modest achievement with so much effort." Nevertheless, says Del Mar, the program is "perhaps the best shot that could ever
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Contact: Andrew Hyde
ahyde@plos.org
44-122-346-3330
Public Library of Science
5-Jun-2006