The American Journal of Medicine
Volume 118, Issue 5 , Pages 521-528 , May 2005

Group versus individual academic detailing to improve the use of antihypertensive medications in primary care: a cluster-randomized controlled trial

  • Steven R. Simon, MD, MPH

      Affiliations

    • Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts
    • Corresponding Author InformationRequests for reprints should be addressed to Steven R. Simon, MD, MPH, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, Sixth Floor, Boston, MA 02215.
    • ,
  • Sumit R. Majumdar, MD, MPH

      Affiliations

    • Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts
    • Division of General Internal Medicine, University of Alberta, Edmonton, Alberta, Canada
    • ,
  • Lisa A. Prosser, PhD

      Affiliations

    • Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts
    • ,
  • Susanne Salem-Schatz, ScD

      Affiliations

    • HealthCare Quality Initiatives, Newton, Massachusetts
    • ,
  • Cheryl Warner, MD

      Affiliations

    • Harvard Vanguard Medical Associates, Medford, Massachusetts.
    • ,
  • Ken Kleinman, ScD

      Affiliations

    • Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts
    • ,
  • Irina Miroshnik, MS

      Affiliations

    • Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts
    • ,
  • Stephen B. Soumerai, ScD

      Affiliations

    • Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts

Received 27 August 2004 ,Accepted 19 December 2004.

References 

  1. Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. A cooperative study . JAMA . 1977;237:255–261
  2. The 1980 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure . Arch Intern Med . 1980;140:1280–1285
  3. The 1984 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure . Arch Intern Med . 1984;144:1045–1057
  4. The 1988 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure . Arch Intern Med . 1988;148:1023–1038
  5. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-V) . Arch Intern Med . 1993;153:154–183
  6. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI) . Arch Intern Med . 1997;157:2413–2446
  7. Chobanian AV , Bakris GL , Black HR , et al.   The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (the JNC 7 report) . JAMA . 2003;289:2560–2572
  8. McGlynn EA , Asch SM , Adams J , et al.   The Quality of Health Care Delivered to Adults in the United States . N Engl J Med . 2003;348:2635–2645
  9. ALLHAT Collaborative Research Group . Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone (the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT)) . JAMA . 2000;283:1967–1975
  10. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group . Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic (The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)) . JAMA . 2002;288:2981–2997
  11. Moser M . Why are physicians not prescribing diuretics more frequently in the management of hypertension? . JAMA . 1998;279:1813–1816
  12. Stafford RS , Furberg CD , Finkelstein SN , et al.   Impact of clinical trial results on national trends in alpha-blocker prescribing, 1996–2002 . JAMA . 2004;291:54–62
  13. Freid VM, Prager K, MacKay AP, Xia H. Chartbook on trends in the health of Americans. Health, United States, 2003. Hyattsville, Maryland: National Center for Health Statistics. 2003.
  14. American Heart Association . Heart Disease and Stroke Statistics - 2004 Updated . Dallas, Texas: American Heart Association; 2003;
  15. Inui TS , Yourtee EL , Williamson JW . Improved outcomes in hypertension after physician tutorials (A controlled trial) . Ann Intern Med . 1976;84:646–651
  16. Aucott JN , Pelecanos E , Dombrowski R , et al.   Implementation of local guidelines for cost-effective management of hypertension (A trial of the firm system) . J Gen Intern Med . 1996;11:139–146
  17. Borenstein JE , Graber G , Saltiel E , et al.   Physician-pharmacist comanagement of hypertension (a randomized, comparative trial) . Pharmacotherapy . 2003;23:209–216
  18. Siegel D , Lopez J , Meier J , et al.   Academic detailing to improve antihypertensive prescribing patterns . Am J Hypertens . 2003;16:508–511
  19. Soumerai SB , Avorn J . Principles of educational outreach (’academic detailing’) to improve clinical decision making . JAMA . 1990;263:549–556
  20. Educational outreach visits (effects on professional practice and health outcomes (Cochrane review)) . Oxford: Update Software; 1999;
  21. Soumerai SB , Lipton HL , Majumdar SR . Evaluating and improving drug prescribing . In:  Strom B editors. Pharmacoepidemiology . New York: John Wiley & Sons; 2000;
  22. Majumdar SR , Guirguis LM , Toth EL , et al.   Controlled Trial of a Multifaceted Intervention for Improving Quality of Care for Rural Patients With Type 2 Diabetes . Diabetes Care . 2003;26:3061–3066
  23. van Eijk ME , Avorn J , Porsius AJ , de Boer A . Reducing prescribing of highly anticholinergic antidepressants for elderly people (randomized trial of group versus individual academic detailing) . BMJ . 2001;322:654–657
  24. Diwan VK , Wahlstrom R , Tomson G , et al.   Effects of group detailing on the prescribing of lipid-lowering drugs (a randomized controlled trial in Swedish primary care) . J Clin Epidemiol . 1995;48:705–711
  25. Lundborg CS , Wahlstrom R , Oke T , et al.   Influencing prescribing for urinary tract infection and asthma in primary care in Sweden (a randomized controlled trial of an interactive educational intervention) . J Clin Epidemiol . 1999;52:801–812
  26. Santoso B , Suryawati S , Prawaitasari JE . Small group intervention vs. formal seminar for improving appropriate drug use . Soc Sci Med . 1996;42:1163–1168
  27. Figueiras A , Sastre I , Tato F , et al.   One-to-one versus group sessions to improve prescription in primary care (a pragmatic randomized controlled trial) . Med Care . 2001;39:158–167
  28. Murray DM . Design and analysis of group-randomized trials . New York: Oxford University Press; 1998;
  29. Finkelstein JA , Davis RL , Dowell SF , et al.   Reducing antibiotic use in children (a randomized trial in 12 practices) . Pediatrics . 2001;108:1–7
  30. Clark DO , Von Korff M , Saunders K , et al.   A chronic disease score with empirically derived weights . Med Care . 1995;33:783–795
  31. Putnam KG , Buist DS , Fishman P , et al.   Chronic disease score as a predictor of hospitalization . Epidemiology . 2002;13:340–346
  32. Massachusetts Board of Registration in Medicine On-Line Physician Profile Site. http://profiles.massmedboard.org/Profiles/MA-Physician-Profile-Find-Doctor.asp Accessed: August 1, 2004
  33. Rhode Island Board of Medical Licensure and Discipline: Doc-Finder. Available at. http://www.docboard.org/ri/df/search.htm Accessed: August 1, 2004
  34. Ray WA , Schaffner W , Federspiel CF . Persistence of improvement in antibiotic prescribing in office practice . JAMA . 1985;253:1774–1776
  35. America’s Health Insurance Plans. Available at: www.aahp.org Accessed: August 1, 2004

 Funding/Support: This work was supported by a cooperative agreement (U18 HS 12019) from the Agency for Healthcare Research and Quality. Dr. Majumdar is a Population Health Investigator of the Alberta Heritage Foundation for Medical Research and a New Investigator of the Canadian Institutes of Health Research. Drs. Simon and Soumerai are investigators in the HMO Research Network Center for Education and Research in Therapeutics funded by the Agency for Healthcare Research and Quality (U18HS010391).Role of the Sponsor: The funders had no role in the design of the study, analysis of the data, interpretation of the results, or the decision to publish.

PII: S0002-9343(05)00044-6

doi: 10.1016/j.amjmed.2004.12.023

The American Journal of Medicine
Volume 118, Issue 5 , Pages 521-528 , May 2005

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