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Table 4 Studies targeting the management of hypertension and/or hypercholesterolaemia

From: Improving prescribing of antihypertensive and cholesterol-lowering drugs: a method for identifying and addressing barriers to change

Study Objective Intervention Comment
Bass 1986 [15] Improve the detection and management of hypertension Medical assistant oversaw screening, attended to education, compliance and follow-up We did not consider this to be a feasible intervention in our setting
Aucott 1996 [19] Implement guidelines for cost-effective management of hypertension on medication use and cost, blood pressure control, and other resource use Intensive guideline-based education and supervision (identification of clinical champion, faculty education and development, assignment of PharmD, clinic-based education and precepting of clinicians, monthly feedback to practice) Most elements of this multifaceted intervention were already included in our own. The trial was conducted in a general internal medicine teaching clinic, which limits the relevance to our primary care setting
Rossi 1997 [16] Alter prescribing habits for the treatment of hypertension Guideline reminders placed in the charts of patients Computerised reminders were already included as part of our multifaceted intervention
Goldberg 1998 [17] Increase compliance with national guidelines for the primary care of hypertension (and depression) Academic detailing with or without continuous quality improvement (CQI) teams Academic detailing (outreach visit) was already included as part of our multifaceted intervention. The study-findings did not support the use of CQI teams
Maclure 1998 [18] Increase understanding of the way in which dissemination of evidence changes medical practice Media stories, national warning letter, teleconference, small group workshops, and newsletters Our outreach visits were planned as interactive sessions, thus serving the same purpose as small group workshops or teleconferences. We did not believe that passive distribution of material would be useful
Hetlevik 1998 [21] Implement clinical guidelines in the treatment of hypertension Computer based clinical decision support system, mailed feedback of current practice, invitation to seminar at conference Most interventions were already included in our multifaceted intervention. We did not believe that inviting to conference-seminar would be useful
van der Weijden 1999 [23] Assess the feasibility and evaluation needs of a cholesterol guideline Group education, desktop supportive materials, feedback on performance, and face-to-face instruction on location Most interventions were already included in our multifaceted intervention
Montgomery 2000 [20] Have an effect on absolute cardiovascular risk, blood pressure, and prescribing of cardiovascular drugs Computer based clinical decision support system plus cardiovascular risk chart; or cardiovascular risk chart alone Both interventions were already included in our multifaceted intervention
Demakis 2000 [22] Improve resident physician compliance with standards of ambulatory care (including hypertension) Computerised reminder system Intervention was already included in our multifaceted intervention