One-to-One Versus Group Sessions to Improve Prescription in Primary Care

Abstract

The objective of the study was to evaluate the effectiveness of 2 educational strategies aimed at improving prescribing standards in primary care. A pragmatic controlled trial was designed; the study population included general and family practitioners in Galicia (northwestern Spain) divided into 3 study groups: a one-to-one education group (n = 98), a by-group education group (n = 92), and a control group (n = 405). The educational intervention included explicit recommendations for selecting nonsteroidal anti-inflammatory drugs (NSAIDs) for inflammation signs. Some of the subjects were given reminders. Mixed-effect linear models were applied to data analysis. Analyses were done by intention-to-treat. The dependent variable is a rate with a numerator that is the number of prescribed units of the NSAIDs recommended during intervention; the denominator is the total number of prescribed units of the NSAID total. One-to-one education obtained an average prescribing behavior improvement of 6.5% (P <0.001) in the 9 months after intervention. In the education group, the average improvement was 2.4% (P <0.05) for the same period. Statistically significant differences were observed between the group intervention and one-to-one groups. The reminder increased significantly the effectiveness of the one-to-one intervention. A single, short educational session to primary care doctors can improve their prescribing standards during long periods of ≥9 months. Of the 2 strategies followed in the trial, one-to-one education has shown to be the most effective. Results also show that the effectiveness of these interventions increases when presented together with written material.