Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners1999
Addressing barriers to change: an RCT of practice-based education to improve the management of hypertension in the elderly.
Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
14 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Tailored interventions to address determinants of practice.The Cochrane database of systematic reviews · 2015Pooled it
- Audit and feedback: effects on professional practice and healthcare outcomes.The Cochrane database of systematic reviews · 2012Pooled it
- Interventions used to improve control of blood pressure in patients with hypertension.The Cochrane database of systematic reviews · 2010Pooled it
- Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes.The Cochrane database of systematic reviews · 2010Pooled it
- Improving prescribing of antihypertensive and cholesterol-lowering drugs: a method for identifying and addressing barriers to change.BMC health services research · 2004Trial
- Cluster randomised controlled trial of an educational outreach visit to improve influenza and pneumococcal immunisation rates in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2002Trial
- Cluster randomised controlled trial of tailored interventions to improve the management of urinary tract infections in women and sore throat.BMJ (Clinical research ed.) · 2002Trial
- Prevalence, management and control of hypertension in older adults on admission to hospital.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2017Article
- Theoretical domains framework to assess barriers to change for planning health care quality interventions: a systematic literature review.Journal of multidisciplinary healthcare · 2016Review
- Prevalence, prescribing and barriers to effective management of hypertension in older populations: a narrative review.Journal of pharmaceutical policy and practice · 2015Article
- Essential pediatric hypertension: defining the educational needs of primary care pediatricians.BMC medical education · 2014Article
- A realist review of interventions and strategies to promote evidence-informed healthcare: a focus on change agency.Implementation science : IS · 2013Review
- Identifying barriers and tailoring interventions to improve the management of urinary tract infections and sore throat: a pragmatic study using qualitative methods.BMC health services research · 2003Article
- Barriers to hypertension care and control.Current hypertension reports · 2000Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the future, primary care groups (PCGs) will have to consider how best to apply audit and education to fulfil their commitment to clinical governance and to facilitate the implementation of research findings.
aimTo establish whether an exploration of 'barriers to change' can enhance the effectiveness of an educational intervention designed to improve the management of hypertension in the elderly.
methodA parallel-arm, randomized, single-blind, controlled trial of practice-based educational visits in 18 practices. These practices had previously taken part in a multipractice audit of the management of hypertension in the elderly. Both groups received outreach visits in their own practice, during which they received the results of the previous audit. The nine 'intervention' practices were encouraged to explore barriers that would prevent them from implementing pertinent research findings. The control group was not encouraged to do this. The main outcome measure of the trial was determined in advance as 'the stated management of systolic hypertension in patients aged 70 to 79'. A secondary endpoint was the stated management of a specific patient scenario. The endpoints were tested by questionnaire before and after the educational intervention.
resultsFor the primary endpoint, there was a statistically significant difference in the stated threshold for treating systolic hypertension between intervention and control groups after the visits (161.8 mmHg versus 167.2 mmHg; P = 0.007). For the secondary endpoint, there was also a statistically significant difference between the two groups, after the visits, in their willingness to treat a 70-year-old male with mild hypertension (89% of doctors would treat in the intervention group versus 57% in the control group; P = 0.047).
conclusionThe effectiveness of an educational intervention is significantly improved by addressing the barriers preventing practitioners from implementing the findings of research.
Indexed as
Identifiers
10621984PMC1313469What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.