BACKGROUND: Conventional dissemination of clinical trial results has inconsistent impact on physician practices. A more comprehensive plan to influence determinants of prescribing practices is warranted. PURPOSE: To report the response from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial to the National Heart, Lung, and Blood Institute's requirement for dissemination and evaluation of trials with potential immediate public health applicability. METHODS: ALLHAT's dissemination plan had two-components: (1) a traditional approach of media coverage, scientific presentation, and publication; and (2) a theory-based approach targeting determinants of clinician behavior. Strategies included: (1) academic detailing, in which physicians approach colleagues regarding blood pressure management, (2) direct patient messages to stimulate communication with physicians regarding blood pressure control, (3) approaches to formulary systems to use educational and economic incentives for evidence-based prescription, and (4) direct professional organization appeals to clinicians. RESULTS: One hundred and forty-seven Investigator Educators reported 1698 presentations to 18,524 clinicians in 41 states and the District of Columbia. The pre- and post-test responses of 1709 clinicians in the face-to-face meetings indicated significant changes in expectations for positive patient outcomes and intention to prescribe diuretics. Information was mailed to 55 individuals representing 20 professional organizations and to eight formulary systems. Direct-to-patient messages were provided to 14 sites that host patient newsletters and Web sites such as health plans and insurance companies, 62 print mass media outlets, and 12 broadcast media sites. LIMITATIONS: It was not within the scope of the project to conduct a randomized trial of the impact of the dissemination. However, impact evaluation using quasi-experimental designs is ongoing. CONCLUSION: A large multi-method dissemination of clinical trial results is feasible. Planning for dissemination efforts, including evaluation research, should be considered as a part of the funding and design of the clinical trial and should begin early in trial planning.
BACKGROUND: Conventional dissemination of clinical trial results has inconsistent impact on physician practices. A more comprehensive plan to influence determinants of prescribing practices is warranted. PURPOSE: To report the response from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial to the National Heart, Lung, and Blood Institute's requirement for dissemination and evaluation of trials with potential immediate public health applicability. METHODS:ALLHAT's dissemination plan had two-components: (1) a traditional approach of media coverage, scientific presentation, and publication; and (2) a theory-based approach targeting determinants of clinician behavior. Strategies included: (1) academic detailing, in which physicians approach colleagues regarding blood pressure management, (2) direct patient messages to stimulate communication with physicians regarding blood pressure control, (3) approaches to formulary systems to use educational and economic incentives for evidence-based prescription, and (4) direct professional organization appeals to clinicians. RESULTS: One hundred and forty-seven Investigator Educators reported 1698 presentations to 18,524 clinicians in 41 states and the District of Columbia. The pre- and post-test responses of 1709 clinicians in the face-to-face meetings indicated significant changes in expectations for positive patient outcomes and intention to prescribe diuretics. Information was mailed to 55 individuals representing 20 professional organizations and to eight formulary systems. Direct-to-patient messages were provided to 14 sites that host patient newsletters and Web sites such as health plans and insurance companies, 62 print mass media outlets, and 12 broadcast media sites. LIMITATIONS: It was not within the scope of the project to conduct a randomized trial of the impact of the dissemination. However, impact evaluation using quasi-experimental designs is ongoing. CONCLUSION: A large multi-method dissemination of clinical trial results is feasible. Planning for dissemination efforts, including evaluation research, should be considered as a part of the funding and design of the clinical trial and should begin early in trial planning.
Authors: Lewis B Morgenstern; Lara Staub; Wenyaw Chan; Theodore H Wein; L Kay Bartholomew; Mary King; Robert A Felberg; W Scott Burgin; Janet Groff; Susan L Hickenbottom; Kamaldeen Saldin; Andrew M Demchuk; Anjali Kalra; Anupma Dhingra; James C Grotta Journal: Stroke Date: 2002-01 Impact factor: 7.914
Authors: Aram V Chobanian; George L Bakris; Henry R Black; William C Cushman; Lee A Green; Joseph L Izzo; Daniel W Jones; Barry J Materson; Suzanne Oparil; Jackson T Wright; Edward J Roccella Journal: Hypertension Date: 2003-12-01 Impact factor: 10.190
Authors: Randall S Stafford; L Kay Bartholomew; William C Cushman; Jeffrey A Cutler; Barry R Davis; Glenna Dawson; Paula T Einhorn; Curt D Furberg; Linda B Piller; Sara L Pressel; Paul K Whelton Journal: Arch Intern Med Date: 2010-05-24
Authors: Laurel Liang; Susanne Bernhardsson; Robin W M Vernooij; Melissa J Armstrong; André Bussières; Melissa C Brouwers; Anna R Gagliardi Journal: Implement Sci Date: 2017-02-27 Impact factor: 7.327
Authors: Maria E Fernandez; Chelsey R Schlechter; Guilherme Del Fiol; Bryan Gibson; Kensaku Kawamoto; Tracey Siaperas; Alan Pruhs; Tom Greene; Inbal Nahum-Shani; Sandra Schulthies; Marci Nelson; Claudia Bohner; Heidi Kramer; Damian Borbolla; Sharon Austin; Charlene Weir; Timothy W Walker; Cho Y Lam; David W Wetter Journal: Implement Sci Date: 2020-01-30 Impact factor: 7.327
Authors: Jessica D Austin; Serena A Rodriguez; Lara S Savas; Tina Megdal; Lois Ramondetta; Maria E Fernandez Journal: Front Public Health Date: 2020-12-18