title: A multifaceted intervention according to the Audit Project Odense method improved secondary prevention of ischemic heart disease: a randomised controlled trial.
abstract: BACKGROUND
  No single quality improvement instrument has proved consistently effective, but multifaceted interventions are believed to have the greatest impact. However, only little is known regarding what combinations are likely to be successful.
  
  
  OBJECTIVE
  To evaluate the impact of a multifaceted intervention strategy combining GP registrations, outreach visits and feedback, targeting secondary prevention of ischemic heart disease in general practice.
  
  
  METHODS
  A randomised controlled trial including 28 GPs in Ringkjøbing County, Denmark. Half of the GPs received outreach visits and feedback on their prescribing of heart disease drugs. Evaluation was based on registration of consultations with patients suffering from ischemic heart disease.
  
  
  RESULTS
  The intervention had a statistically significant impact on prescribing of lipid lowering drugs [odds ratio 1.59; 95% confidence interval (CI) 1.00 to 2.53] and acetylsalicylic acid (odds ratio 2.54; 95% CI 1.21 to 5.31).
  
  
  CONCLUSIONS
  An intervention strategy combining outreach visits, feedback and GP registrations is a promising way of improving the quality of preventive treatment in general practice.
authors.affiliation: Research Unit for General Practice, University of Southern Denmark, Odense, Denmark. js@alm.au.dk
authors.forename: Jens
authors.initials: J
authors.lastname: Søndergaard
authors.forename: Dorte Gilså
authors.initials: DG
authors.lastname: Hansen
authors.forename: Peter
authors.initials: P
authors.lastname: Aarslev
authors.forename: Anders P
authors.initials: AP
authors.lastname: Munck
mesh_terms: D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000517:prevention & control*; D009313:National Health Programs; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'; D011315:Preventive Medicine / Q000379:methods*