Evidence map›Paper›PMID 28335809›Full record

Trial reportTrials2017

Poor uptake of an online intervention in a cluster randomised controlled trial of online diabetes education for rural general practitioners.

Christine L Paul, Leon Piterman, Jonathan E Shaw, Catherine Kirby, Kristy L Forshaw, Jennifer Robinson, Isaraporn Thepwongsa, Robert W Sanson-Fisher

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Trials, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Christine L PaulHunter Medical Research Institute, New Lambton Heights, Newcastle, NSW, Australia. Chris.Paul@newcastle.edu.au.
Leon PitermanMonash University, School of Rural Health, Churchill, VIC, Australia.
Jonathan E ShawBaker IDI Heart and Diabetes Institute, Clinical Diabetes and Epidemiology Group, Melbourne, VIC, Australia.
Catherine KirbyMonash University, School of Rural Health, Churchill, VIC, Australia.
Kristy L ForshawHunter Medical Research Institute, New Lambton Heights, Newcastle, NSW, Australia.
Jennifer RobinsonHunter Medical Research Institute, New Lambton Heights, Newcastle, NSW, Australia.
Isaraporn ThepwongsaDepartment of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Robert W Sanson-FisherHunter Medical Research Institute, New Lambton Heights, Newcastle, NSW, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn Australia, rural and remote communities have high rates of diabetes-related death and hospitalisation. General practitioners (GPs) play a major role in diabetes detection and management. Education of GPs could optimise diabetes management and improve patient outcomes at a population level. The study aimed to describe the uptake of a continuing medical education intervention for rural GPs and its impact on the viability of a cluster randomised controlled trial of the effects of continuing medical education on whole-town diabetes monitoring and control.

methodTrial design: the cluster randomised controlled trial involved towns as the unit of allocation and analysis with outcomes assessed by de-identified pathology data (not reported here). The intervention programme consisted of an online active learning module, direct electronic access to specialist advice and performance feedback. Multiple rounds of invitation were used to engage GPs with the online intervention content. Evidence-based strategies (e.g. pre-notification, rewards, incentives) were incorporated into the invitations to enrol in the programme. Recruitment to the programme was electronically monitored through the hosting software package during the study intervention period.

resultsEleven matched pairs of towns were included in the study. There were 146 GPs in the 11 intervention towns, of whom 34 (23.3%) enrolled in the programme, and 8 (5.5%) completed the online learning module. No town had more than 10% of the resident GPs complete the learning module. There were no contacts made by GPs regarding requests for specialist advice. Consequently, the trial was discontinued.

conclusionThere is an ongoing need to engage primary care physicians in improving diabetes monitoring and management in rural areas. Online training options, while notionally attractive and accessible, are not likely to have high levels of uptake, even when evidence-based recruitment strategies are implemented.

trial registrationAustralian New Zealand Clinical Trials Registry, identifier: ACTRN12611000553976 . Retrospectively registered on 31 May 2011.

Indexed as

Attitude of Health PersonnelInternetRural Health ServicesSample SizeAustraliaComputer-Assisted InstructionDiabetes Mellitus, Type 2Education, Medical, ContinuingGeneral PractitionersHealth Knowledge, Attitudes, PracticeHumansPhysicians, Primary CareResearch SubjectsGeneral practiceMedical educationOnline educationRural medicineType 2 diabetes

Identifiers

PMID28335809
PMCPMC5364574

What OpenQuestion holds

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Registered trials

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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.