Changing physician prescribing patterns through problem-based learning: an interactive, teleconference case-based education program and review of problem-based learning.
BACKGROUND
Although asthma guidelines have recommended the use of anti-inflammatory controller medications since 1991, studies have consistently shown widespread failure to follow the guidelines. Major barriers include lack of knowledge and the inability to operationalize knowledge. Improved continuing medical education methods should result in more effective learning by physicians and other health care professionals, leading to better adherence to guidelines, resulting in better outcomes.


OBJECTIVE
To evaluate the effectiveness of an interactive, case-based, educational intervention, also known as problem-based learning, using a series of interactive, case-based teleconferences.


METHODS
A series of interactive, case-based teleconferences was completed with 20 primary care physicians. Each case involved a child aged 16 months to 12 years with asthma. A 12-month analysis of physician prescribing patterns was conducted.


RESULTS
Program acceptance by the 20 physicians was uniformly positive. Significant improvement was noted, with an overall increase in controller use. Review of prescription data showed an increase in inhaled corticosteroid use from an average of 2.54 to 7.76 refills per month for the 6 months after the intervention (P < .001).


CONCLUSIONS
After participating in a unique educational intervention-problem-based learning using interactive, case-based teleconferences-the prescribing patterns of physicians were altered significantly toward better adherence to asthma guidelines, as demonstrated by an increased use of anti-inflammatory controller medications (inhaled corticosteroids and leukotriene antagonists).
Division of Allergy and Pulmonary Medicine, St. Louis Children's Hospital, Washington University Medical School, St. Louis, Missouri, USA. AHCHU1@aol.com
Ray S
RS
Davis
Don A
DA
Bukstein
Allan T
AT
Luskin
Josh A
JA
Kailin
Gail
G
Goodenow
D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004502:Education, Medical, Continuing / Q000379:methods / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D010821:Physicians, Family / Q000523:psychology*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D018794:Problem-Based Learning; D015397:Program Evaluation; D013685:Telecommunications; D014922:Wisconsin
D018927:Anti-Asthmatic Agents