Getting clinical trial results into practice: design, implementation, and process evaluation of the ALLHAT Dissemination Project.
Getting clinical trial results into practice: design, implementation, and process evaluation of the ALLHAT Dissemination Project.
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DOI：
10.1177/1740774509338234
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发表时间：
2009-08
期刊：
影响因子：
--
通讯作者：
Allhat Collaborative Research Group
中科院分区：
文献类型：
--
作者：
Bartholomew LK;Cushman WC;Cutler JA;Davis BR;Dawson G;Einhorn PT;Graumlich JF;Piller LB;Pressel S;Roccella EJ;Simpson L;Whelton PK;Williard A;Allhat Collaborative Research Group
临床试验结果的传统传播对医生实践的影响不一致。一个更全面的计划，以影响处方做法的决定因素是必要的。报告抗高血压和降脂治疗预防心脏病发作试验对国家心脏、肺和血液研究所要求的传播和评价具有潜在直接公共卫生适用性的试验的响应。ALLHAT的传播计划有两个组成部分：1）媒体报道，科学演示和出版的传统方法; 2）以理论为基础的方法，针对临床医生行为的决定因素。策略包括：（1）学术细节，医生在血压管理方面与同事接触，（2）直接向患者传达信息，以刺激与医生在血压控制方面的沟通，（3）采用处方集系统的方法，使用教育和经济激励措施进行循证处方，以及（4）直接向临床医生发出专业组织呼吁。147名研究者教育者向41个州和哥伦比亚特区的18,524名临床医生报告了1698次报告。1709名临床医生在面对面会议中的测试前和测试后的反应表明，对积极的患者结局的期望和开利尿剂的意图发生了显着变化。信息邮寄给代表20个专业组织的55名个人和8个处方集系统。向14个主办患者通讯和网站的网站（如健康计划和保险公司）、62个印刷大众媒体和12个广播媒体网站提供了直接面向患者的信息。对传播的影响进行随机试验不属于该项目的范围。然而，目前正在使用准实验设计进行影响评价。临床试验结果的大规模多方法传播是可行的。传播工作的规划，包括评价研究，应被视为临床试验的资助和设计的一部分，并应在试验规划的早期开始。
Conventional dissemination of clinical trial results has inconsistent impact on physician practices. A more comprehensive plan to influence determinants of prescribing practices is warranted. 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. 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. 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. 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. 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.
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影响因子：
158.5
作者：
Gershlick, AH;Stephens-Lloyd, A;Wilcox, R
通讯作者：
Wilcox, R
影响因子：
3.2
作者：
Davis, BR;Cutler, JA;Hawkins, CM
通讯作者：
Hawkins, CM
DOI：
10.1001/jama.1967.03130240070013
发表时间：
1967-01-01
影响因子：
--
作者：
通讯作者：
--
影响因子：
8.3
作者：
Alderman, MH
通讯作者：
Alderman, MH
影响因子：
120.7
作者：
Cleeman, JI;Grundy, SM;Murray, EZ
通讯作者：
Murray, EZ