Elsevier

Preventive Medicine

Volume 35, Issue 5, November 2002, Pages 422-429
Preventive Medicine

Regular Article
Improving Quality of Organizing Cardiovascular Preventive Care in General Practice by Outreach Visitors: A Randomized Controlled Trial☆

https://doi.org/10.1006/pmed.2002.1095Get rights and content

Abstract

Background. Adequate care for patients with cardiovascular risks requires an adequate practice organization. Educational outreach visits are a promising approach to modifying professional behavior. We aimed to assess whether the quality of cardiovascular preventive care in general practice can be improved through a comprehensive intervention implemented by an educational outreach visitor.

Methods. After baseline measurements, general practices (n = 124) in the southern half of The Netherlands were randomly allocated to either intervention or control group. The intervention, based on the educational outreach model, comprised 15 practice visits over a period of 21 months and addressed a large number of issues around task delegation, availability of instruments and patient leaflets, record-keeping, and follow-up routines. Twenty-one months after the start of the intervention, postintervention measurements were performed. The difference between ideal and actual practice in each aspect of organizing preventive care was defined as a deficiency score. Primary outcome measure was the difference in deficiency scores before and after the intervention.

Results. All practices completed both baseline and postintervention measurements. The difference in change between intervention and control group adjusted for baseline was statistically significant (P < 0.001) for each aspect of organizing preventive care. The largest absolute improvement was found for the number of preventive tasks performed by the practice assistant.

Conclusions. This study showed that a comprehensive intervention implemented by outreach visitors was effective in improving organization of cardiovascular preventive care in general practice.

References (32)

  • TJ Bowker et al.

    A British Cardiac Society survey of the potential for the secondary prevention of coronary disease: ASPIRE (Action on Secondary Prevention through Intervention to Reduce Events)

    Heart

    (1996)
  • PA Carney et al.

    Tools, teamwork, and tenacity: an office system for cancer prevention

    J Fam Pract

    (1992)
  • LL Dickey et al.

    The Put Prevention into Practice campaign: office tools and beyond

    J Fam Pract

    (1994)
  • LS Leininger et al.

    An office system for organizing preventive services: a report by the American Cancer Society Advisory Group on Preventive Health Care Reminder Systems

    Arch Fam Med

    (1996)
  • AJ Dietrich et al.

    Changing office routines to enhance preventive care. The preventive GAPS approach

    Arch Fam Med

    (1994)

    • Cited by (0)

    ☆

    This study was supported by a research grant from The Netherlands Heart Foundation. Thanks go to all outreach visitors and all staff members of the practices who participated.

    2

    To whom correspondence and reprint requests should be addressed at Department of General Practice, Room Ff 325, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. Fax: +31-10-4089491. E-mail: [email protected].

    View full text
    Copyright © 2002 American Health Foundation and Elsevier Science (USA). All rights reserved.