Physician attitudes toward strategies to promote the adoption of medical evidence into clinical practice.
BACKGROUND
[corrected] Promoting the adoption of medical evidence into clinical practice has been advocated as one approach to improving healthcare quality and reducing medical errors. Data describing the effectiveness of different strategies to achieve this goal in real-world settings are limited.


OBJECTIVE
To determine the effectiveness of selected interventions on the adoption of medical evidence into clinical practice.


METHODS
A cross-sectional survey of a random sample of physicians selected from the American Medical Association's Physician Master File.


METHODS
We examined the perceived effectiveness of 7 strategies (represented by 27 individual interventions) and 5 general approaches for promoting the adoption of medical evidence into clinical practice in 1100 practicing physicians. Respondent exposure to interventions was also determined. Regression analyses were performed to identify factors that affected effectiveness ratings. Analysis of variance was used to test the hypothesis of equal mean scores across different comparison groups.


RESULTS
Of 1,100 surveys mailed, 63 (5.7%) were excluded and 431 were completed (response rate = 41.6%). Mean +/- SD effectiveness scores for the 27 individual interventions on a 5-point Likert scale ranged from 2.0 +/- 0.9 (literature received from insurance companies and managed care organizations) to 4.2 +/- 0.8 (one-on-one communication with respected colleagues). Ranges for the 7 strategies were 2.6 +/- 1.0 (patient-mediated interventions) to 3.6 +/- 0.9 (educational meetings) and for the 5 general approaches were 1.98 +/- 0.9 (administrative interventions) to 3.3 +/- 0.8 (provider education). The hypothesis of equal mean effectiveness scores was rejected for all comparisons (P < .001). Frequency of exposure was the only variable to predict effectiveness (P < .001 for all regression models).


CONCLUSIONS
From the perspective of practicing physicians, the frequency of exposure to strategies for promoting the adoption of medical evidence into clinical practice strongly affects their perceived effectiveness.
Borenstein
Jeff
J
Department of Medicine and Health Services Research, Cedars-Sinai Health System, and Zynx Health Inc, Los Angeles, Calif 90212, USA.
Chiou
Chiun-Fang
CF
Henning
James M
JM
Wilson
Alisa
A
Hohlbauch
Andriana A
AA
Richards
Margaret S
MS
Ofman
Joshua J
JJ
Weingarten
Scott R
SR
D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014481:United States