The Article in Brief
Case-Based Training of Evidence-Based Clinical Practice in Primary Care and Decreased Mortality in Patients With Coronary Heart Disease
Anna Kiessling , and colleagues
Background This study is one of the first to evaluate the impact of physician continuing medical education on patient outcomes. Specifically, the study examined whether case-based training, designed to help general practitioners manage patients with hyperlipidemia (high levels of fat in the blood, such as cholesterol and triglycerides), increased 10-year survival in patients with coronary heart disease.
What This Study Found Patients of physicians who participated in case-based training had a 10-year mortality rate one-half that of patients whose physicians who didn�t take the training. In addition to a standard lecture and mailing of new evidence-based treatment guidelines received by all physicians who participated in the study, the physicians in the intervention group participated in small-group seminars, facilitated by a cardiologist, which encouraged the discussion of cases and active problem solving. After 10 years, 22 percent of the patients in the intervention group had died compared with 44 percent of patients in the control group, a difference mainly attributed to reduced cardiovascular mortality. The 22 percent mortality rate in the intervention group was comparable to the rate of 23 percent seen in patients treated by a comparison group of cardiology and internal medicine specialists.
Implications
- Based on these findings, the authors call for case-based training to be tested in other areas of clinical practice.