Cluster-randomized controlled trial of dissemination strategies of an online quality improvement programme for alcohol-related disorders.
OBJECTIVE
This project investigated different dissemination strategies of an online quality improvement programme for alcohol-related disorders into routine care in South Baden and South Württemberg in Germany.


METHODS
In a cluster-randomized controlled trial, 112 general practices were randomized into three groups. The first group (n = 43) received access to the online system and a training programme for the general practitioners (GPs). The second group (n = 42) additionally received education for the whole practice team. The third group (n = 27) acted as control and received only access to the online system.


RESULTS
Two thousand six hundred and forty-seven practitioners were asked to take part in the study, and it was possible to randomize 112 (4%) practices. There were no significant differences concerning the use of the system between the groups: 41.9% of the GPs in the first group, 42.9% in the second group and 44.4% in the control group used the system. In terms of only the system users, 55.6% of the GPs in the first group, 33.3% in the second group and 8.3% in the control group used the system six times or more (P = 0.019). Diagnostic assessments made by the GPs in the groups differed substantially: 72.2% of diagnoses in the first group were correct, while this figure lay at 69.7% in the second group and 36.4% in the control group (P = 0.034).


CONCLUSIONS
No effect of the additional training on the primary outcome (acceptance) was identified, but on two of the secondary outcomes. Further cost-effectiveness studies should investigate whether the effort involved in providing training additionally to the system is justifiable. The study is registered at ClinicalTrials.gov: NCT00314067. This article conforms to the guidelines in the Consolidated Standards of Reporting Trials (CONSORT) statement (Moher et al., 2001; Campbell et al., 2004).
Ruf
D
D
Department of Psychiatry and Psychotherapy, Section of Clinical Epidemiology and Health Services Research, University Medical Centre Freiburg, D-79104 Freiburg, Germany. daniela.ruf@uniklinik-freiburg.de
Berner
M
M
Kriston
L
L
Lohmann
M
M
Mundle
G
G
Lorenz
G
G
Niebling
W
W
Härter
M
M
D019973:Alcohol-Related Disorders / Q000175:diagnosis*; D004502:Education, Medical, Continuing / Q000379:methods*; D004506:Education, Nursing / Q000379:methods; D055317:Evidence-Based Practice / Q000379:methods; D005194:Family Practice / Q000193:education* / Q000379:methods; D005260:Female; D006801:Humans; D033181:Information Dissemination / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009726:Nurses; D009862:Online Systems; D015397:Program Evaluation; D011787:Quality of Health Care