Continuing medical education for asthma in primary care settings: a review of randomised controlled trials

Abstract

Background: The aim of this paper is to review evidence of the effectiveness of educational interventions for General Practitioners for health outcomes of patients with asthma. Methods: The 'Research and Development Resource Base in CME' was searched in addition to searches of the Cochrane, Medline, CINAHL and ERIC databases for original articles published between 1966 and October 2002. Inclusion criteria for the studies were that, the study was a randomised controlled trial (RCT), that the intervention included physician education, and that the effect of the intervention on patient health outcomes was reported. Results: Three studies were identified that met our selection criteria and had an appropriate study design. One of these studies found health benefits for paediatric patients however these benefits were mostly lost when patients were followed up two years later. The other two studies found no health benefits from provider education. Conclusions: Based on the studies available, no recommendations can be made on the effectiveness of CME for improving health outcomes of patients with asthma. However, absence of evidence does not imply absence of effect, so further controlled trials are needed to evaluate the effectiveness of this intervention in primary care settings. The challenges of conducting trials in primary care settings are discussed.