IMPACT OF EDUCATION FOR PHYSICIANS ON PATIENT OUTCOMES

Objectives. This study was conducted to assess the impact of an intera ctive seminar based on self-regulation theory on 1) the treatment prac tices and communications and education behavior of physicians, 2) the health status and medical care utilization of their pediatric patients with asthma, and 3) the satisfaction with care of the subjects' paren ts. Methods. A total of 74 general practice pediatricians were assigne d to either a program or a control group in a randomized controlled st udy. Data were collected from physicians at baseline, and 69 (93%) pro vided follow-up data 5 months after the program. Data were also collec ted from 637 of their patients at baseline, and in a 22-month window a fter the intervention, 472 (74%) of this number provided follow-up dat a. Results. After the seminar, physicians in the program group were mo re likely than were control group physicians to address patients' fear s about medicines, review written instructions, provide a sequence of educational messages, write down how to adjust the medicines at home w hen symptoms change, and report that they spent less time with their p atients. Parents of the children treated by program physicians were si gnificantly more likely than were control group parents to report that the physician had been reassuring, described as a goal that the child be fully active, and gave information to relieve specific worries. Af ter a visit with the physician, these parents were also more likely to report that they knew how to make management decisions at home. After the intervention compared to controls, patients of physicians in the program group were more likely to have received a prescription for inh aled antiinflammatory medicine and to have been asked by the physician to demonstrate how to use a metered-dose inhaler. After the intervent ion, children seen by program physicians made significantly fewer none mergency office visits and visits for follow-up of an episode of sympt oms; however, there were no differences in emergency department visits and hospitalizations. Among children who were placed on inhaled corti costeroids during this study, however, children treated by physicians who had received education had significantly fewer symptoms and fewer follow-up office visits, nonemergency physician office visits, emergen cy department visits, and hospitalizations. Conclusions. The interacti ve seminar based on theories of self-regulation led to patient-physici an encounters that were of shorter duration, had significant impact on the prescribing and communications behavior of physicians, led to mor e favorable patient responses to physicians' actions, and led to reduc tions in health care utilization.