Elsevier

Preventive Medicine

Volume 29, Issue 6, December 1999, Pages 478-486
Preventive Medicine

Regular Article
Randomized Controlled Trial of a Computer Strategy to Increase General Practitioner Preventive Care,☆☆

https://doi.org/10.1006/pmed.1999.0567Get rights and content

Abstract

Background. Previous interventions targeting primary care practitioners with the aim of increasing preventive care delivery have demonstrated limited effectiveness. The primary aim of this study was to assess the effectiveness of a computerized continuing medical education program to increase rates of three screening behaviors (cholesterol, blood pressure, and cervical screening) and to identify three risk behaviors (smoking, alcohol consumption, benzodiazepine use) in general practice.

Methods. Nineteen general practitioners were randomly allocated to intervention or control conditions. Those given the intervention received a computerized feedback system. The intervention was delivered using a touchscreen computer located in the surgery waiting area. The preventive behaviors of interest were patient smoking, alcohol use, benzodiazepine use, and blood pressure, cholesterol and cervical screening using the Papanicolou test. Differences in performance by group in each of the outcomes was measured at baseline and 3-month follow-up. Logistic regression analyses with generalized estimating equations were conducted as the main analyses.

Result. At 3-month follow-up, statistically significant differences were evident in the following outcome measures: accurate classification of benzodiazepine users (z = 2.8540, P < 0.05); accurate classification of non-benzodiazepine users (z = 2.7339, P < 0.05); accurate classification of hazardous or harmful alcohol drinkers (z = 2.3079, P < 0.02); blood pressure screening (z = 3.4136, P < 0.001); and cholesterol screening (z = 6.6313, P < 0.001).

Conclusion. A computerized system of performance-specific feedback was effective at increasing some preventive care services in general practice.

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  • Cited by (0)

    The authors acknowledge the contibutions of the following people: John Pallas, Kate D'Este, and Bob Gibberd for statistical advice and Julie Kolupacovski, Andrew Coxall, Brian Swain, Rod Allen, and Jackie Murnain for computer programming. The collaboration of the general practitioners, their staff, and patients is also gratefuly acknowledged.

    ☆☆

    The project received funding from the Commonwealth General Practice Evaluation Program and the NSW Cancer Council.

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    To whom correspondence and reprint requests should be sent at the current address: Newcastle Institute of Public Health, Level 2, David Maddison Building, Royal Newcastle Hospital, PO Box 664J, Newcastle, NSW 2300, Australia. Fax: 02 49236323. E-mail: [email protected].

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