Drug treatment of stable angina pectoris and mass dissemination of therapeutic guidelines: a randomized controlled trial.
BACKGROUND
Public agencies responsible for implementing health care policies often adapt and disseminate clinical practice guidelines, but the effectiveness of mass dissemination of guidelines is unknown.


OBJECTIVE
To study the effects of guideline dissemination on physicians' prescribing practices for the treatment of stable angina pectoris.


METHODS
Randomized controlled trial.


METHODS
A sample of 3293 Quebec physicians were randomly assigned to receive a one-page summary of clinical practice guidelines on the treatment of stable angina (in February 1999), to receive the summary and a reminder (in February and March 1999, respectively), or to receive no intervention (controls). The prescribing profiles of participants, as well as sociodemographic characteristics of the physicians and their patients, were examined for June-December 1999.


RESULTS
The intervention had no effect on prescription rates of beta-blockers, antiplatelet agents, or hypolipaemic drugs. Compared to 1997 data for the same physicians, there was an overall 10% increase in appropriate prescription rates, irrespective of the intervention.


CONCLUSIONS
In-house production and dissemination of clinical practice guidelines may not improve physicians' practice patterns if there is pre-existing substantial scientific consensus on the issue.
Beaulieu
M-D
MD
Chaire docteur Sadok Besrour en médecine familiale, Centre de recherche du Centre Hospitalier de l'Université de Montréal, Quebec, Canada. maried.beaulieu@sympatico.ca
Brophy
J
J
Jacques
A
A
Blais
R
R
Battista
R
R
Lebeau
R
R
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy*; D002983:Clinical Competence; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011792:Quebec
D000319:Adrenergic beta-Antagonists; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors