Management of hypertension in private practice: A randomized controlled trial in continuing medical education

Abstract

A randomized controlled trial was used to evaluate a physician education program designed to improve physician management of patients' hypertension, patient hypertension-related behaviors, and patient diastolic blood pressure. One hundred eleven private-practice physicians received medication education, behavioral education, both kinds of education, or no education. The educational program, which had either a medication or behavioral focus, consisted of individualized feedback reports based on medical record reviews and patient surveys, an educational syllabus, and a one-hour telephone conference call. Patient diastolic blood pressure improved significantly in all four groups, but there were no differences between the control group and the three groups receiving education. Educated physicians improved their response to abnormal laboratory tests and increased counseling about medication regimen, side effects, and sodium reduction, but conservative probability levels adjusting for the number of analyses rendered all these results nonsignificant. It was suggested that because both physicians and patients have longstanding habits, more intensive CME programs are required to improve physician performance and patient outcome.