title: Arriba: effects of an educational intervention on prescribing behaviour in prevention of CVD in general practice.
abstract: BACKGROUND
  Evidence on the effectiveness of educational interventions on prescribing behaviour modification in prevention of cardiovascular disease is still insufficient. We evaluated the effects of a brief educational intervention on prescription of hydroxymethylglutaryl-CoA reductase inhibitors (statins), inhibitors of platelet aggregation (IPA), and antihypertensive agents (AH).
  
  
  METHODS
  Cluster randomised controlled trial with continuous medical education (CME) groups of general practitioners (GPs).
  
  
  METHODS
  Prescription of statins, IPA, and AH were verified prior to study start (BL), immediately after index consultation (IC), and at follow-up after 6 months (FU). Prescription in patients at high risk (>15% risk of a cardiovascular event in 10 years, based on the Framingham equation) and no prescription in low-risk patients (≤ 15%) were considered appropriate.
  
  
  RESULTS
  An intervention effect on prescribing could only be found for IPA. Generally, changes in prescription over time were all directed towards higher prescription rates and persisted to FU, independent of risk status and group allocation.
  
  
  CONCLUSIONS
  The active implementation of a brief evidence-based educational intervention on global risk in CVD did not lead directly to risk-adjusted changes in prescription. Investigations on an extended time scale would capture whether decision support of this kind would improve prescribing risk-adjusted sustainably.
authors: Department of General Practice, University of Marburg, Karl-von-Frisch-Strasse 4, Marburg, Germany. kellerhe@staff.uni-marburg.de
authors: Heidemarie
authors: H
authors: Keller
authors: Tanja
authors: T
authors: Krones
authors: Annette
authors: A
authors: Becker
authors: Oliver
authors: O
authors: Hirsch
authors: Andreas C
authors: AC
authors: Sönnichsen
authors: Uwe
authors: U
authors: Popert
authors: Petra
authors: P
authors: Kaufmann-Kolle
authors: Justine
authors: J
authors: Rochon
authors: Karl
authors: K
authors: Wegscheider
authors: Erika
authors: E
authors: Baum
authors: Norbert
authors: N
authors: Donner-Banzhoff
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003661:Decision Support Techniques; D011307:Drug Prescriptions; D004502:Education, Medical, Continuing; D005260:Female; D058006:General Practice; D005858:Germany; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011314:Preventive Health Services; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents; D002317:Cardiovascular Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors