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Table 1 Elements of the tailored intervention

From: Rational Prescribing in Primary Care (RaPP-trial). A randomised trial of a tailored intervention to improve prescribing of antihypertensive and cholesterol-lowering drugs in general practice [ISRCTN48751230]

Educational outreach visit

   • Presentation focusing on three main messages:

1. Relevance of risk estimation and how to do it, including strategies on how to communicate information about risk to patients.

2. Information on evidence in support of effect and the unjustified fear of adverse effects regarding thiazides, pointing at the consensus that exists among guidelines. Attention also directed to the importance of clinically relevant endpoints when studies are quoted.

3. Clear recommendations justified by referring to high degree of consensus among guidelines.

   • Guidelines handed out, directing attention to the authors (opinion leaders)

Audit & feed-back at outreach visit

   • To what extent treatment goals are achieved.

   • Drug-choice profile on antihypertensives

   • Level of risk among patients on treatment, compared to a sample (men 40–65 years) not on treatment

Computerised reminders

   • Risk assessment

   • First-choice antihypertensive drugs

   • Treatment goals

Risk assessment tools as charts and in electronic format

Patient-information material

   • The relationship between single risk factors and global risk

   • Thiazides and beta-blockers.

   • Treatment goals

Follow-up

   • Telephone call to the practice within 1–3 days to check that software has not led to any difficulties

   • Short telephone call to each physician after 1–3 months