gms | German Medical Science

Background: Every physician taking part in the DMP CAD gets a feedback report summarizing the data of his vs. all patients included in the DMP. Some of these feedback reports were endowed with a CME report on medical therapy of CAD as recommended by the guidelines.

Objective: Does participation in CME activities lead to higher guideline compliance in medical therapy of CAD?

Results: Between 2005 and 2010 eight CME reports have been published (rate of participation 3.4–16.9%). Taken sex, age, duration of DMP participation, comorbidity, coronary interventions, and other medical prescriptions into account CME activity was a significant predictor of the prescription of Aspirin (OR 1.53, 95% CI 1.48–1.57), beta blockers (1.11, 1.08–1.13), ACE inhibitors (1.15, 1.10–1.21), statines (1.17, 1.15–1.20), and normotensive blood pressure (1.12, 1.09–1.14), but not of referrals to a specialist (1.04, 0.94–1.16). Time courses of prescription of Aspirin and statines showed continuously higher rates among patients of physicians who took part in CME where too a slight tendency towards an increase in statines’ prescription could be seen. However, single specific CME reports did not cause an extra increase in prescription rates.

Discussion: In an area with relatively stable guideline recommendations for many years, those physicians who take care of their knowledge base also care more about their performance. CME reports may support such a secular trend but do not show a temporal relation to prescription behaviour.

Implications: Besides dissemination and updating of knowledge the process of guideline implementation needs to focus on alternative strategies too.