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M9490508.TXT
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Document 0508
DOCN M9490508
TI Improving office-based physician's prevention practices for sexually
transmitted diseases.
DT 9411
AU Rabin DL; Boekeloo BO; Marx ES; Bowman MA; Russell NK; Willis AG;
Georgetown University School of Medicine, Washington, D.C.
SO Ann Intern Med. 1994 Oct 1;121(7):513-9. Unique Identifier : AIDSLINE
MED/94346704
AB OBJECTIVE: To determine whether office-based interventions increase
primary care physicians' risk assessment of and counseling practices for
patients regarding sexually transmitted diseases and the human
immunodeficiency virus (HIV). DESIGN: Randomized controlled clinical
trial. SETTING: Washington, D.C., Metropolitan Statistical Area. STUDY
PARTICIPANTS: Office-based primary care physicians (family or general
practice, internal medicine, and obstetrics-gynecology). INTERVENTION:
Mailed educational materials alone or coupled with a simulated patient
instructor office visit. MEASUREMENTS: Self-reported and observed
frequency of assessing and counseling patients regarding their risk
factors for sexually transmitted diseases and HIV infection.
Participants were interviewed by telephone before and after the
intervention (n = 757). A subset of participants (n = 194) was also
observed after the intervention by simulated patient evaluators in
blinded office visits. RESULTS: 89% of physicians who received both
educational materials and a simulated patient instructor visit reported
that they reviewed the educational materials compared with 53% of those
who only received the educational materials (P < or = 0.001). Physicians
in the combined intervention group had higher self-reported and observed
rates for several risk assessment questions and counseling
recommendations than did physicians in the control group or the group
that only received educational materials. Seventy-three percent of
physicians of the combined intervention group reported an increase in
counseling patients about reducing risky sexual behavior compared with
53% of the group receiving only educational materials and 42% of the
control group (P < or = 0.001). CONCLUSIONS: Mailed educational
materials combined with an office visit by a simulated patient
instructor for role-play and feedback on clinical performance increased
the frequency of office-based physicians' risk assessment and risk
reduction counseling of patients for sexually transmitted diseases and
HIV infection.
DE Counseling Education, Medical, Continuing/*METHODS Feedback Human
HIV Infections/*PREVENTION & CONTROL Patient Education *Physician's
Practice Patterns *Practice Management, Medical Role Playing Sexually
Transmitted Diseases/*PREVENTION & CONTROL Support, Non-U.S. Gov't
Support, U.S. Gov't, P.H.S. CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED
CONTROLLED TRIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).