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Results of a Randomized Trial in Antihypertensive Care

C. Edward Evans, MB, BS; R. Brian Haynes, MD, PhD; Nicholas J. Birkett, MD, MSc; J. Raymond Gilbert, MD, MSc; D. Wayne Taylor, MA; David L. Sackett, MD, MSc(Epid); Mary E. Johnston; Sheila A. Hewson

JAMA. 1986;255(4):501-504.

Abstract
Evidence is sparse concerning the value of the "educational" materials that physicians receive in the mail. We conducted a randomized trial of a mailed continuing education program on hypertension for primary care physicians. Although formal pretesting documented that the program led to significant improvements in physician knowledge over the short term, the current study showed no lasting effect on physician knowledge (mean scores on an end-of-study questionnaire were 50% and 52% for study and control physicians, respectively) and no influence on performance in lowering the blood pressures of patients referred from screening (mean blood pressure drop for study patients, 12.2/10.4 mm Hg vs 13.0/10.6 mm Hg for control patients). The chance that we missed a difference in diastolic blood pressure as great as 3 mm Hg is less than 5%. Resources spent on instructional materials mailed to physicians may be wasted.

(JAMA 1986;255:501-504)

Author Affiliations
From the Departments of Family Medicine (Drs Evans and Gilbert), Clinical Epidemiology and Biostatistics (Drs Haynes, Birkett, Gilbert, and Sackett, Mr Taylor, and Mss Johnston and Hewson), and Medicine (Drs Haynes and Sackett), Faculty of Health Sciences, McMaster University, Hamilton, Ontario.

Footnotes
Reprint requests to Department of Family Medicine, McMaster Health Sciences Center, 1200 Main St W, Hamilton, Ontario, Canada L8N 3Z5 (Dr C. E. Evans).

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