TY - JOUR
T1 - A randomized trial to implement practice recommendations
T2 - Design and methods of the Dementia Care Study
AU - Holloway, Robert G.
AU - Gifford, David R.
AU - Frankel, Martin R.
AU - Vickrey, Barbara G.
N1 - Funding Information:
Ted Munsat had the foresight to facilitate this effort, and he and Robert Griggs generously supported the work of developing the proposal and carrying out the project. We are grateful to AAN Presidents Ken Viste and Steve Ringel for their continuous support and to Oliver Fein and Lewis Rowland for their counsel. Elliott Mancall and Anne Lambert were instrumental in the production of the CONTINUUM Dementia Care course, and we thank Richard Kravitz, Alvin Mushlin, and Carol Dingleday for critiquing sections of the course. We could not have carried out the project without the enthusiastic participation of the Advisory Panel: Ken Kosik, Steven Greenberg, John Morris, James Sabry, Gerry Honch, Ralph Jozefowicz, John Wolf, Stuart Factor, Venkat Ramani, Frederick Munschauer, Linda Hershey, Ronald Kanner, Gary Kaplan, Richard Libman, Jerome Posner, Stanley Turhim, Mary Ann Corasaniti, Bonnie Goldstein, Jenny Osborn, Jean Marks, Marvin Leroy, Mary Ann Richard, Karen Drumm, and John Jager. We thank Carol Albright for her programming support and cheerful assistance in the project. Finally, Sue Rodmyre and Ashley Crittenden masterfully coordinated the project and were invaluable to it and to us. This work was supported by an unrestricted grant from the New York State Department of Health (Albany, NY, Comptroller #C-012600).
PY - 1999/8
Y1 - 1999/8
N2 - The objective of the Dementia Care Study was to design, implement, and evaluate, in a randomized controlled trial a multi-faceted, specialty-society sponsored intervention to encourage neurologists' adoption of practice recommendations. Eligible participants were 417 neurologists in six regions in New York State (NYS) who were identified through the American Academy of Neurology (AAN) Membership Database and the NYS Physician Masterfile. An Advisory Panel of experts on dementia, neurologists who were local opinion leaders, and local representatives of the Alzheimer's Association guided the development of the intervention. The intervention included six components: (1) a mailing of six practice recommendations in a course of continuing medical education (CME) sponsored by the AAN; (2) a mailing of supplementary, practice-based tools; (3) follow-up mailings reinforcing the recommendations; (4) an invitation to an AAN-sponsored seminar; (5) endorsement by opinion leaders; and (6) specialty-society sponsorship and endorsement. The primary outcome measure was neurologists' decision-making, as assessed through a mailed survey that used detailed clinical scenarios. Intervention and control neurologists received the survey six months after the intervention, and a baseline group received it three months prior to the intervention. To evaluate the concordance of responses to scenarios with actual processes of care, we reviewed medical records in one study region. Secondary outcome measures included number of patient referrals received by the local Alzheimer's Associations and by the Association's National Safe Return Program. The specialty society, the opinion leaders, the dementia experts, local advocacy groups, and the study investigators achieved a high degree of collaboration. Specialty societies can integrate within their educational programs the capability to design and evaluate the impact of novel strategies to encourage the adoption of practice recommendations that are linked to improved quality of care. Control Clin Trials 1999;20:369-385 Copyright (C) 1999 Elsevier Science Inc.
AB - The objective of the Dementia Care Study was to design, implement, and evaluate, in a randomized controlled trial a multi-faceted, specialty-society sponsored intervention to encourage neurologists' adoption of practice recommendations. Eligible participants were 417 neurologists in six regions in New York State (NYS) who were identified through the American Academy of Neurology (AAN) Membership Database and the NYS Physician Masterfile. An Advisory Panel of experts on dementia, neurologists who were local opinion leaders, and local representatives of the Alzheimer's Association guided the development of the intervention. The intervention included six components: (1) a mailing of six practice recommendations in a course of continuing medical education (CME) sponsored by the AAN; (2) a mailing of supplementary, practice-based tools; (3) follow-up mailings reinforcing the recommendations; (4) an invitation to an AAN-sponsored seminar; (5) endorsement by opinion leaders; and (6) specialty-society sponsorship and endorsement. The primary outcome measure was neurologists' decision-making, as assessed through a mailed survey that used detailed clinical scenarios. Intervention and control neurologists received the survey six months after the intervention, and a baseline group received it three months prior to the intervention. To evaluate the concordance of responses to scenarios with actual processes of care, we reviewed medical records in one study region. Secondary outcome measures included number of patient referrals received by the local Alzheimer's Associations and by the Association's National Safe Return Program. The specialty society, the opinion leaders, the dementia experts, local advocacy groups, and the study investigators achieved a high degree of collaboration. Specialty societies can integrate within their educational programs the capability to design and evaluate the impact of novel strategies to encourage the adoption of practice recommendations that are linked to improved quality of care. Control Clin Trials 1999;20:369-385 Copyright (C) 1999 Elsevier Science Inc.
KW - Dementia
KW - Education
KW - Physician behavior
KW - Practice guidelines
KW - Quality of care
UR - http://www.scopus.com/inward/record.url?scp=0033064499&partnerID=8YFLogxK
U2 - 10.1016/S0197-2456(99)00006-9
DO - 10.1016/S0197-2456(99)00006-9
M3 - Article
C2 - 10440564
AN - SCOPUS:0033064499
SN - 0197-2456
VL - 20
SP - 369
EP - 385
JO - Controlled Clinical Trials
JF - Controlled Clinical Trials
IS - 4
ER -