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

Grudniewicz A, Kealy R, Rodseth RN, Hamid J, Rudoler D, Straus SE - Implement Sci (2015)

Bottom Line: 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.No significant effect was found on clinically important patient outcomes, physician behaviour, or physician cognition when PEMs were compared to usual care.

View Article: PubMed Central - PubMed

Affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, Canada. a.grudniewicz@mail.utoronto.ca.

ABSTRACT

Background: Printed 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.

Methods: We 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.

Results: Our 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.

Conclusions: PEMs 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 registration: PROSPERO, CRD42013004356.

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Related in: MedlinePlus

Identification of eligible studies.
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Related In: Results  -  Collection

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Fig1: Identification of eligible studies.

Mentions: From the 16,735 articles retrieved, the literature search resulted in 12,439 citations (duplicates removed) and 146 potentially relevant citations. Forty studies and two companion reports met eligibility criteria. See Fig. 1 for a flow diagram representing identification of eligible studies [11].Fig. 1


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

Grudniewicz A, Kealy R, Rodseth RN, Hamid J, Rudoler D, Straus SE - Implement Sci (2015)

Identification of eligible studies.
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4666153&req=5

Fig1: Identification of eligible studies.
Mentions: From the 16,735 articles retrieved, the literature search resulted in 12,439 citations (duplicates removed) and 146 potentially relevant citations. Forty studies and two companion reports met eligibility criteria. See Fig. 1 for a flow diagram representing identification of eligible studies [11].Fig. 1

Bottom Line: 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.No significant effect was found on clinically important patient outcomes, physician behaviour, or physician cognition when PEMs were compared to usual care.

View Article: PubMed Central - PubMed

Affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, Canada. a.grudniewicz@mail.utoronto.ca.

ABSTRACT

Background: Printed 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.

Methods: We 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.

Results: Our 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.

Conclusions: PEMs 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 registration: PROSPERO, CRD42013004356.

Show MeSH
Related in: MedlinePlus