Article
Effect of continuing medical education (CME) activities on quality of medical therapy in patients with coronary artery disease (CAD). Results from the disease management programme (DMP) CAD in the North Rhine region, Germany
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Authors
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B. Hagen
- Central Research Institute for Ambulatory Health Care in Germany, Cologne, Germany
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I. Schwang
- St. Marien-Hospital, Department of Cardiology, Hamm, Germany
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L. Altenhofen
- Central Research Institute for Ambulatory Health Care in Germany, Cologne, Germany
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R. Griebenow
- Cologne-Merheim Hospital, Department of Cardiology, Cologne, Germany
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J. Kretschmann
- Central Research Institute for Ambulatory Health Care in Germany, Cologne, Germany
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A. Weber
- Central Research Institute for Ambulatory Health Care in Germany, Cologne, Germany
| Published: | July 10, 2012 |
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Outline
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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.
