Direct mailing of consensus recommendations did not alter GPs' knowledge and prescription of oestrogen in the menopause

Abstract

Objective — To investigate the impact of an information-package (direct mailing) concerning oestrogen therapy, deriving from a consensus conference in 1990, on general practitioners' (GPs') attitudes and knowledge.

Design and subjects — Controlled randomised study. Two groups of Norwegian GPs. The Intervention group received an information-package consisting of the recommendations from the consensus conference, some headline questions with answers, and a classification of the oestrogens available in Norway, including a table and a graphical presentation of the costs of the different treatments. GPs stated their views on prescribing oestrogen on a five step scale, related to nine short case histories, each containing cues on complaints, smoking, family history suggesting risk for cardiovascular disease, and osteoporosis.

Main outcome measures — GPs' views on prescribing oestrogen, relation to age, sex, practice type (solo/group) and practice location.

Results — The differences in answer distributions between the Intervention (n=193) and Control (n=181) groups did not reach statistical significance for any of the nine case histories. The answers indicate a more liberal attitude towards replacement therapy in 1992 compared to a study performed in 1990. The views on contraindications was fundamentally unaltered.

Conclusion — The study did not reveal any significant effect of direct mailing as means of disseminating consensus conference recommendations to GPs.

Key Words:

• estrogen replacement therapy
• randomized controlled trials
• family practice
• guidelines
• consensus development conferences