title: Implementing research findings into practice using clinical opinion leaders: barriers and lessons learned.
abstract: BACKGROUND
  An opinion leader-driven intervention to improve practice guideline-based medication management for patients with schizophrenia was tested at four Department of Veterans Affairs health care facilities. The concept of using opinion leaders as disseminators of research evidence and internal agents of change has been widely reported.
  Each intervention site received an intensive, multicomponent intervention during the course of one year. The project's process evaluation included ongoing brief surveys of physicians' attitudes and behaviors, logs of reports from opinion leader conference calls, and interviews with the opinion leaders toward the end of the implementation period.
  Several barriers or problematic issues surfaced: (1) physicians do not always agree on who is an opinion leader; some sites may have no opinion leader; (2) some sites had poorly developed formal and informal social networks among physicians; (3) a focus on physicians only as agents of change; and (4) how much directive should be given to the opinion leaders concerning how to influence attitudes and behaviors?
  
  
  CONCLUSIONS
  Four major problematic issues encountered during the project offer potential solutions for addressing them.
authors.affiliation: Central Arkansas Veterans Healthcare System, Little Rock, USA. CurranGeoffreyM@uams.edu
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Curran
authors.forename: Carol R
authors.initials: CR
authors.lastname: Thrush
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Smith
authors.forename: Richard R
authors.initials: RR
authors.lastname: Owen
authors.forename: Mona
authors.initials: M
authors.lastname: Ritchie
authors.forename: Dale
authors.initials: D
authors.lastname: Chadwick
mesh_terms: D019317:Evidence-Based Medicine; D019983:Guideline Adherence / Q000458:organization & administration*; D006801:Humans; D033181:Information Dissemination / Q000379:methods*; D007857:Leadership; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care / Q000458:organization & administration