title: Effects of distance learning on clinical management of LUTS in primary care: a randomised trial.
abstract: 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.
authors.affiliation: Centre for Quality of Care Research (WOK), 229, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. r.wolters@wok.umcn.nl
authors.forename: René
authors.initials: R
authors.lastname: Wolters
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
authors.forename: Maarten
authors.initials: M
authors.lastname: Klomp
authors.forename: Toine
authors.initials: T
authors.lastname: Lagro-Jansen
authors.forename: Chris van
authors.initials: Cv
authors.lastname: Weel
authors.forename: Richard
authors.initials: R
authors.lastname: Grol
mesh_terms: 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
chemical_list: D017430:Prostate-Specific Antigen