Trial reportQuality in health care : QHC1999
Can small group education and peer review improve care for patients with asthma/chronic obstructive pulmonary disease?
Trial report in Quality in health care : QHC, 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 7 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care.The Cochrane database of systematic reviews · 2022Pooled it
- Continuing education meetings and workshops: effects on professional practice and healthcare outcomes.The Cochrane database of systematic reviews · 2021Pooled it
- IMPNPJ primary care respiratory medicine · 2018Pooled it
- Patient-mediated interventions to improve professional practice.The Cochrane database of systematic reviews · 2018Pooled it
- Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2017Pooled it
- Interventions to modify health care provider adherence to asthma guidelines: a systematic review.Pediatrics · 2013Pooled it
- Continuing education meetings and workshops: effects on professional practice and health care outcomes.The Cochrane database of systematic reviews · 2009Pooled it
- Impact of quality circles for improvement of asthma care: results of a randomized controlled trial.Journal of evaluation in clinical practice · 2008Trial
- What is the role of quality circles in strategies to optimise antibiotic prescribing? A pragmatic cluster-randomised controlled trial in primary care.Quality & safety in health care · 2007Trial
- Improving clinician self-efficacy does not increase asthma guideline use by primary care clinicians.Academic pediatricsTrial
- Persons With Chronic Obstructive Pulmonary Disease and High Levels of Activation Improved Their Physical Activity Skills After an Educational Session.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2024Article
- Probation clients' barriers to access and use of opioid use disorder medications.Health & justice · 2019Article
- Guideline for Care of Patients With the Diagnoses of Craniosynostosis: Working Group on Craniosynostosis.The Journal of craniofacial surgery · 2015Article
- Clinical practice guidelines in the AANS/CNS Section on Tumors: past, present and future directions.Journal of neuro-oncology · 2014Article
- Article
- The cultivation of esteem and retrieval of scientific knowledge in physician networks.Journal of health and social behavior · 2010Article
- The gap between evidence-based medicine and daily practice in the management of paediatric asthma. A pharmacy-based population study from The Netherlands.European journal of clinical pharmacology · 2006Article
- Research methods used in developing and applying quality indicators in primary care.Quality & safety in health care · 2002Article
- Practice guidelines and measurement: state-of-the-science.Nursing outlookReview
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo study the effectiveness of an intensive small group education and peer review programme aimed at implementing national guidelines on asthma/chronic obstructive pulmonary disease (COPD) on care provision by general practitioners (GPs) and on patient outcomes.
designA randomised experimental study with pre-measurement and post-measurement (after one year) in an experimental group and a control group in Dutch general practice. SUBJECTS AND
interventionTwo groups of GPs were formed and randomised. The education and peer review group (17 GPs with 210 patients) had an intervention consisting of an interactive group education and peer review programme (four sessions each lasting two hours). The control group consisted of 17 GPs with 223 patients (no intervention).
main outcome measuresKnowledge, skills, opinion about asthma and COPD care, presence of equipment in practice; actual performance about peakflow measurement, non-pharmacological and pharmacological treatment; asthma symptoms (Dutch Medical Research Council), smoking habits, exacerbation ratio, and disease specific quality of life (QOL-RIQ). Data were collected by a written questionnaire for GPs, by self recording of consultations by GPs, and by a written self administered questionnaire for adult patients with asthma/COPD.
resultsData from 34 GP questionnaires, 433 patient questionnaires, and recordings from 934 consultations/visits and 350 repeat prescriptions were available. Compared with the control group there were only significant changes for self estimated skills (+16%, 95% confidence interval 4% to 26%) and presence of peakflow meters in practice (+18%, p < 0.05). No significant changes were found for provided care and patient outcomes compared with the control group. In the subgroup of more severe patients, the group of older patients, and in the group of patients not using anti-inflammatory medication at baseline, no significant changes compared with the control group were seen in patient outcomes.
conclusionExcept for two aspects, intensive small group education and peer review in asthma and COPD care do not seem to be effective in changing relevant aspects of the provided care by GPs in accordance with guidelines, nor in changing patients' health status.
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