BackgroundPrinted educational materials (PEMs) are commonly used simple interventions that can be used alone or with other interventions to disseminate clinical evidence. They have been shown to have a small effect on health professional behaviour. However, we do not know whether they are effective in primary care. We investigated whether PEMs improve primary care physician (PCP) knowledge, behaviour, and patient outcomes.MethodsWe conducted a systematic review of PEMs developed for PCPs. Electronic databases were searched for randomized controlled trials, quasi randomized controlled trials, controlled before and after studies, and interrupted time series. We combined studies using meta-analyses when possible. Statistical heterogeneity was examined, and meta-analysis was performed using a random effects model when significant statistical heterogeneity was present and a fixed effects model otherwise. The template for intervention description and replication (TIDieR) checklist was used to assess the quality of intervention description.ResultsOur search identified 12,439 studies and 40 studies met our inclusion criteria. We combined outcomes from 26 studies in eight meta-analyses. No significant effect was found on clinically important patient outcomes, physician behaviour, or physician cognition when PEMs were compared to usual care. In the 14 studies that could not be included in the meta-analyses, 14 of 71 outcomes were significantly improved following receipt of PEMs compared to usual care. Most studies lacked details needed to replicate the intervention.ConclusionsPEMs were not effective at improving patient outcomes, knowledge, or behaviour of PCPs. Further trials should explore ways to optimize the intervention and provide detailed information on the design of the materials.Protocol registrationPROSPERO, CRD42013004356Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0347-5) contains supplementary material, which is available to authorized users.

Technologies in Health (CADTH) was selected a priori as data source for this review of systematic reviews. The review was limited to high quality SRs of interventions targeting clinicians. Results A total of 12 SRs met study inclusion criteria. These SRs suggest that implementation strategies, such as audit and feedback, academic detailing, and educational meetings, are generally effective in improving providers' behaviours, with small to moderate effect sizes. Discussion This review of SRs provides support for the overall efficacy of guideline implementation strategies, while highlighting the need for further comparative and cost effectiveness research to address gaps in the knowledge identified (e.g., limited information on head-to-head comparisons between strategies, clinical context, and cost of interventions). Implications for Guideline Developers/Users Guideline developers should include recommendations for guideline implementation in their future guidelines. Making specific recommendations on choosing one implementation strategy over the others should be avoided until further head-to-head comparisons are available. Background Print and online materials such as guideline summaries are commonly used to distribute evidence to primary care physicians; they are easy to implement and scale across many primary clinics. Objectives We sought to determine: 1) if providing primary care physicians with print and online educational materials has an effect on physician behaviour or on patient outcomes, 2) how these materials were developed, and 3) whether design attributes impact outcomes. Methods We systematically identified studies that reported a print or online educational intervention for primary care physicians. Studies were identified by searching four electronic databases, scanning reference lists, and contacting experts. A subanalysis was conducted to collect data on how these materials were developed and on their use of design principles. Results Thirty studies met eligibility criteria after full-text screening. Studies targeted physician advice-giving behaviour, diagnostic procedures, prescribing behaviour, change in knowledge, and clinical patient outcomes. Results suggest that print and online materials targeted at primary care physicians have little to no effect on outcomes. Discussion Print and online educational materials provided to primary care physicians have little effect on physician or patient outcomes. This is concerning as they are a common method of disseminating evidence. Most studies do not describe how interventional materials were developed or whether design principles were applied. Implications for Guideline Developers/Users Design principles should be considered when developing evidence-based materials and the development processes should be described in order to determine if better designs influence uptake and use of evidence. P217 THE EFFECT OF PRINT OR ONLINE EDUCATIONAL MATERIALS FOR PRIMARY CARE PHYSICIANS: A SYSTEMATIC REVIEW