Knowledge and health care resource allocation: CME/CPD course guidelines-based efficacy

Background: Most Health Care Systems consider Continuing Medical Education a
potential tool to improve quality of care and reduce disease management costs. Its efficacy
in general practitioners needs to be further explored. Objective: This study assesses
the effectiveness of a one-year continuing medical education/continuing professional
development course for general practitioners, regarding the improvement in knowledge
of ARIA and GINA guidelines and compliance with them in asthma management.
Methods: Sixty general practitioners, covering 68,146 inhabitants, were randomly
allocated to continuing medical education/continuing professional development (five
residential events + four short distance-learning refresher courses over one year) or no
training. Participants completed a questionnaire after each continuing medical education
event; key questions were repeated at least twice. The Local Health Unit prescription
database was used to verify prescription habits (diagnostic investigations and
pharmacological therapy) and hospitalizations over one year before and after training.
Results: Fourteen general practitioners (46.7%) reached the cut-off of 50% attendance
of the training courses. Knowledge improved significantly after training (p<0.001,
correct answers to key questions +13%). Training resulted in pharmaceutical cost containment
(trained general practitioners +0.5% vs controls +18.8%) and greater attention
to diagnosis and monitoring (increase in spirometry +63.4%, p<0.01). Conclusion:
This study revealed an encouraging impact of educational events on improvement
in general practitioner knowledge of guidelines and daily practice behavioral
changes. Long-term studies of large populations are required to assess the effectiveness
of education on the behavior of physicians in asthma management, and to establish the
best format for educational events.