Repeated, case-based medical training for primary care physicians can save lives of heart patients, according to a novel randomized case-control study from Karolinska Institutet. The current study is one of the first to evaluate the impact of physician continuing medical education (CME) on patient outcomes.
The results, which is published in the Annals of Family Medicine, showed that patients treated by physicians who participated in case-based training promoting evidence-based care for coronary heart disease had half the 10-year mortality rate than patients whose physicians' didn't take the training. All concerned physicians in the study region received a standard lecture and mailing of new evidence-based treatment guidelines. In addition to this, the 26 primary care physicians in the intervention group participated in several small-group seminars, facilitated by a well-known cardiologist, which encouraged the discussion of cases and active problem solving.
After 10 years, 22 percent of the 45 patients in the intervention group had died as compared with 44 percent of the 43 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.
In light of these findings, the authors call for case-based training to be tested in other areas of clinical practice. In an accompanying editorial, Dr David Davis of the Association of American Medical Colleges asserts that the published findings make it clear that CME has an important and necessary role to play in health care delivery. He also calls on the medical community to broaden its definition of CME.
- A. Kiessling, M. Lewitt, P. Henriksson. Case-Based Training of Evidence-Based Clinical Practice in Primary Care and Decreased Mortality in Patients With Coronary Heart Disease. The Annals of Family Medicine, 2011; 9 (3): 211 DOI: 10.1370/afm.1248
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