Abstract
BackgroundIn spite of numerous guidelines for evidence based diagnostic and therapy adequate knowledge of current recommendations is disappointingly low. In the Hypertension Evaluation Project (HEP I) we showed that awareness of national hypertension guidelines under German practitioners was less than 25% in the year 2000. This indicates the need for efficient strategies to relevantly improve guideline awareness.MethodsTo asses different tools for amending guideline knowledge we used three strategies (guideline in print, interactive guideline, expert seminars) to train 8325 randomised physicians, who had participated in the HEP I trial. Guideline knowledge of the trained physicians was again tested with the HEP questionnaire and compared to a control group of HEP I physicians.ResultsThe return rate of questionnaires was 57.9% without a significant distinction between the groups. Overall guideline awareness was still low but remarkably improved compared to the results of HEP I (37.1% vs. 23.7%, p < 0.0001). There was no difference between the trained physicians and the control group (35.8% and 35.9% vs. 39.7%, p = n.s.).ConclusionWe investigated the influence of different strategies to improve guideline awareness among German physicians. None of our interventions (guideline in print, interactive guideline, expert seminars) brought a notable benefit compared to control group. However, overall knowledge of guideline contents increased from 23.7% to 37.1% over five years. Therefore, other probably multimodal interventions are necessary to significantly improve guideline awareness beyond spontaneous advancement.Trial RegistrationISRCTN53383289
Highlights
In spite of numerous guidelines for evidence based diagnostic and therapy adequate knowledge of current recommendations is disappointingly low
Intervention groups There were 11 547 general practitioners, internists and cardiologists whose data were kwown from the hypertension evaluation project (HEP I)
The group of physicians with duration of private practice of less 5 years is small as the current data are based on a longitudinal evaluation. The physicians of this group had taken over the practice from physicians from the first study population in 2000. These data show that mailing of printed or interactive information had no positive effect on guideline knowledge of physicians
Summary
The goal of the present study was a systematic comparison of traditional and innovative ways for implementation of guideline knowledge for diagnosis and treatment of hypertension
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