Interventions to improve the delivery of preventive services in primary care.
OBJECTIVE
This review was conducted to determine the effectiveness of different interventions to improve the delivery of preventive services in primary care.


METHODS
MEDLINE searches and manual searches of 21 scientific journals and the Cochrane Effective Professional and Organization of Care of trials were used to identify relevant studies. Randomized controlled trials and controlled before-and-after studies were included if they focused on interventions designed to improve preventive activities by primary care clinicians. Two researchers independently assessed the quality of the studies and extracted data for use in constructing descriptive overviews.


RESULTS
The 58 studies included comprised 86 comparisons between intervention and control groups. Postintervention differences between intervention and control groups varied widely within and across categories of interventions. Most interventions were found to be effective in some studies, but not effective in other studies.


CONCLUSIONS
Effective interventions to increase preventive activities in primary care are available. Detailed studies are needed to identify factors that influence the effectiveness of different interventions.
Hulscher
M E
ME
Centre for Quality of Care Research, University of Nijmegen, The Netherlands. m.hulscher@hsv.kun.nl
Wensing
M
M
Grol
R P
RP
van der Weijden
T
T
van Weel
C
C
D003695:Delivery of Health Care / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education / Q000523:psychology; D006302:Health Services Research; D006801:Humans; D011314:Preventive Health Services / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D015397:Program Evaluation; D015203:Reproducibility of Results; D012107:Research Design; D017749:Total Quality Management / Q000458:organization & administration*