Alcohol and Alcoholism Advance Access published online on November 4, 2009
Alcohol and Alcoholism, doi:10.1093/alcalc/agp079
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Cluster-randomized Controlled Trial of Dissemination Strategies of an Online Quality Improvement Programme for Alcohol-related Disorders
1 Department of Psychiatry and Psychotherapy, Section of Clinical Epidemiology and Health Services Research, University Medical Centre Freiburg, Freiburg, Germany
2 Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
3 Department of Psychiatry and Psychotherapy, University Medical Centre Tübingen, Tübingen, Germany
4 Department of General Medicine, Medical University Tübingen, Tübingen, Germany
5 Department of General Medicine, Medical University Freiburg, Freiburg, Germany
* Corresponding author: Department of Psychiatry and Psychotherapy, Section of Clinical Epidemiology and Health Services Research, University Medical Centre Freiburg, Hauptstr. 5, D-79104 Freiburg, Germany. Tel: +49-761/270-6985; Fax: +49-761/270-6989. E-mail: daniela.ruf{at}uniklinik-freiburg.de
Received 7 May 2009; first review notified 3 September 2009; ; accepted 6 October 2009
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Abstract |
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Aims: This project investigated different dissemination strategies of an online quality improvement programme for alcohol-related disorders into routine care in South Baden and South Württemberg in Germany. Methods: In a cluster-randomized controlled trial, 112 general practices were randomized into three groups. The first group (n = 43) received access to the online system and a training programme for the general practitioners (GPs). The second group (n = 42) additionally received education for the whole practice team. The third group (n = 27) acted as control and received only access to the online system. Results: Two thousand six hundred and forty-seven practitioners were asked to take part in the study, and it was possible to randomize 112 (4%) practices. There were no significant differences concerning the use of the system between the groups: 41.9% of the GPs in the first group, 42.9% in the second group and 44.4% in the control group used the system. In terms of only the system users, 55.6% of the GPs in the first group, 33.3% in the second group and 8.3% in the control group used the system six times or more (P = 0.019). Diagnostic assessments made by the GPs in the groups differed substantially: 72.2% of diagnoses in the first group were correct, while this figure lay at 69.7% in the second group and 36.4% in the control group (P = 0.034). Conclusions: No effect of the additional training on the primary outcome (acceptance) was identified, but on two of the secondary outcomes. Further cost-effectiveness studies should investigate whether the effort involved in providing training additionally to the system is justifiable.
The study is registered at ClinicalTrials.gov: NCT00314067 [ClinicalTrials.gov] .
This article conforms to the guidelines in the Consolidated Standards of Reporting Trials (CONSORT) statement (Moher et al., 2001; Campbell et al., 2004).