title: Preventive evidence into practice (PEP) study: implementation of guidelines to prevent primary vascular disease in general practice protocol for a cluster randomised controlled trial.
abstract: BACKGROUND
  There are significant gaps in the implementation and uptake of evidence-based guideline recommendations for cardiovascular disease (CVD) and diabetes in Australian general practice. This study protocol describes the methodology for a cluster randomised trial to evaluate the effectiveness of a model that aims to improve the implementation of these guidelines in Australian general practice developed by a collaboration between researchers, non-government organisations, and the profession.
  
  
  METHODS
  We hypothesise that the intervention will alter the behaviour of clinicians and patients resulting in improvements of recording of lifestyle and physiological risk factors (by 20%) and increased adherence to guideline recommendations for: the management of CVD and diabetes risk factors (by 20%); and lifestyle and physiological risk factors of patients at risk (by 5%). Thirty-two general practices will be randomised in a 1:1 allocation to receive either the intervention or continue with usual care, after stratification by state. The intervention will be delivered through: small group education; audit of patient records to determine preventive care; and practice facilitation visits adapted to the needs of the practices. Outcome data will be extracted from electronic medical records and patient questionnaires, and qualitative evaluation from provider and patient interviews.
  
  
  CONCLUSIONS
  We plan to disseminate study findings widely and directly inform implementation strategies by governments, professional bodies, and non-government organisations including the partner organisations.
authors: Centre for Primary Health Care and Equity, University of New South Wales, Kensington, NSW 2052, Australia. m.f.harris@unsw.edu.au
authors: Mark F
authors: MF
authors: Harris
authors: Jane
authors: J
authors: Lloyd
authors: John
authors: J
authors: Litt
authors: Mieke
authors: M
authors: van Driel
authors: Danielle
authors: D
authors: Mazza
authors: Grant
authors: G
authors: Russell
authors: Jane
authors: J
authors: Smith
authors: Chris
authors: C
authors: Del Mar
authors: Elizabeth
authors: E
authors: Denney-Wilson
authors: Sharon
authors: S
authors: Parker
authors: Yordanka
authors: Y
authors: Krastev
authors: Upali W
authors: UW
authors: Jayasinghe
authors: Richard
authors: R
authors: Taylor
authors: Nick
authors: N
authors: Zwar
authors: Jinty
authors: J
authors: Wilson
authors: Helen
authors: H
authors: Bolger-Harris
authors: Justine
authors: J
authors: Waters
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002985:Clinical Protocols; D016000:Cluster Analysis; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D058006:General Practice / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D040242:Risk Reduction Behavior