Effects of distance learning on clinical management of LUTS in primary care: a randomised trial.
OBJECTIVE
To determine the effect of a distance learning programme on general practice management of men with lower urinary tract symptoms (LUTS).


METHODS
A cluster randomised controlled trial was performed. General practitioners (GPs) were randomised to a distance learning programme accompanied with educational materials or to a control group only receiving mailed clinical guidelines on LUTS. Clinical management was considered as outcome.


RESULTS
Sixty-three GPs registered care management of 187 patients older than 50 years attending the practice because of LUTS. The intervention group showed a lower referral rate to a urologist (OR: 0.08 (95% CI: 0.02-0.40)), but no effect on PSA testing or prescription of medication. PSA testing tended to be requested more frequently by intervention group GPs. Secondary analysis showed patients in the intervention group received more educational materials (OR: 75.6 (95% CI: 13.60-419.90)).


CONCLUSIONS
The educational programme had impact on clinical management without changing PSA testing. Distance learning is an promising method for continuing education.


CONCLUSIONS
Activating distance learning packages are a potentially effective method for improving professional performance. Emotional matters as PSA testing probably need a more complex approach.
Wolters
René
R
Centre for Quality of Care Research (WOK), 229, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. r.wolters@wok.umcn.nl
Wensing
Michel
M
Klomp
Maarten
M
Lagro-Jansen
Toine
T
Weel
Chris van
Cv
Grol
Richard
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence / Q000592:standards*; D016000:Cluster Analysis; D003663:Decision Trees; D020375:Education, Distance / Q000458:organization & administration*; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D005194:Family Practice / Q000193:education / Q000379:methods / Q000592:standards; D005260:Female; D019983:Guideline Adherence / Q000592:standards; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011320:Primary Health Care / Q000379:methods* / Q000592:standards; D015397:Program Evaluation; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D014555:Urination Disorders / Q000209:etiology
D017430:Prostate-Specific Antigen