What is the effectiveness of printed educational materials on primary care physician knowledge, behaviour, and patient outcomes: a systematic review and meta-analyses

Abstract

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.

Dental health aides in Alaska: A qualitative assessment to improve paediatric oral health in remote rural villages

“…[44][45][46] With respect to quality improvement in a complex setting, the literature suggests that distribution of new guidelines will not be sufficient to improve care delivery. 47 In successful implementation, two mutually reinforcing, evidence-based [48][49][50][51] and theory-informed 52,53 implementation strategies are needed: (i) office policies that fit the practice, patients and local conditions such as a protocol on evidence-based practice guidelines, with algorithms and checklists; and (ii) office practices such as feedback on audit with performance goals. Dental teams supported by their supervisors should create goals for care delivery, and performance should be monitored frequently to meet goals.…”

Sustained improvement in vancomycin dosing and monitoring post-implementation of guidelines: Results of a three-year follow-up after a multifaceted intervention in an Australian teaching hospital

“…Most of the peak organisations advocate for multifaceted interventions when implementing guidelines. 1 Commonly recommended interventions by these organisations are: educational sessions [17], academic detailing [18][19][20], continuing medical education (CME) [21][22], provision of printed educational material [23], use of opinion leaders to endorse guidelines [24], and engaging target populations who will use the guideline [25]. However, the magnitude of effect from Abbreviations: CME, continuing medical education; FMC, Flinders Medical Center; GIN, Guideline International Network; ICCU, Intensive and critical care unit; IOM, Institute of Medicine; JMO, junior medical officer; MRSA, methicillin-resistant Staphylococcus aureus; NHMRC, National Health and Medical Council; NICE, National Institute for Clinical Excellence, SIGN, Scottish Intercollegiate Guideline Network; VRE, vancomycin-resistant Enterococcus.…”

Description of the Risk Management of Medication Errors for Centrally Authorised Products in the European Union

“…Finally, we found that for 78% of products with aRMMs for ME safety concerns, studies were in place to measure the effectiveness of these measures. The effectiveness of educational materials is debated and the materials may not always have the intended effect [23]. Effectiveness studies are important to decide whether RMMs are adequate or should be amended, although the execution often remains a challenge [24][25][26].…”