Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: A Cluster Randomized Trial to Assess the Impact of Opinion Leader Endorsed Evidence Summaries on Improving Quality of Prescribing for Patients With Chronic Cardiovascular Disease
Brief Summary: BACKGROUND: Although much has been written about the influence of local opinion leaders on clinical practice, there have been few controlled studies of their effect, and almost none have attempted to change prescribing in the community for chronic conditions such as congestive heart failure (CHF) or ischemic heart disease (IHD). These two conditions are common and there is very good evidence about how to best prevent morbidity and mortality - and very good evidence that quality of care is, in general, suboptimal. Practice audits have demonstrated that about half of eligible CHF patients are prescribed ACE inhibitors (and fewer still reaching appropriate target doses) and less than one-third of patients with established IHD are prescribed statins (with many fewer reaching recommended cholesterol targets). It is apparent that interventions to improve quality of prescribing are urgently needed.

HYPOTHESIS: An intervention that consists of patient-specific one-page evidence summaries, generated and then endorsed by local opinion leaders, will be able to change prescribing practices of community-based primary care physicians.

DESIGN: A single centre randomized controlled trial comparing an opinion leader intervention to usual care. Based on random allocation of all physicians in one large Canadian health region, patients with CHF or IHD (not receiving ACE inhibitors or statins, respectively) recruited from community pharmacies will be allocated to intervention or usual care. The primary outcome is improvement in prescription of proven efficacious therapies for CHF (ACE inhibitors) or IHD (statins) within 6 months of the intervention.


Options:
A: Arm Label: Intervention group; Type: N/A; Interventions: Behavioral: reminders | Arm Label: current practice group; Type: N/A; Interventions: N/A | Intervention Type: BEHAVIORAL; Name: reminders; Assigned to Arm(s): Intervention group
B: Arm Label: 1- Usual Care; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: 2 - Automated Mailing; Type: EXPERIMENTAL; Interventions: Behavioral: Automated Mailing | Arm Label: 3 - Automated Mailing Plus Assisted; Type: EXPERIMENTAL; Interventions: Behavioral: Automated Mailing Plus Assisted | Arm Label: 4 - Auto Plus Assisted Plus Navigation; Type: EXPERIMENTAL; Interventions: Behavioral: Auto Plus Assisted Plus Navigation | Intervention Type: BEHAVIORAL; Name: Automated Mailing; Assigned to Arm(s): 2 - Automated Mailing | Intervention Type: BEHAVIORAL; Name: Automated Mailing Plus Assisted; Assigned to Arm(s): 3 - Automated Mailing Plus Assisted | Intervention Type: BEHAVIORAL; Name: Auto Plus Assisted Plus Navigation; Assigned to Arm(s): 4 - Auto Plus Assisted Plus Navigation
C: Intervention Type: BEHAVIORAL; Name: Opinion leader generated and endorsed evidence summaries; Assigned to Arm(s): N/A
D: Arm Label: Control; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Educational Reminder | Arm Label: Intervention; Type: EXPERIMENTAL; Interventions: Behavioral: Educational Reminder | Intervention Type: BEHAVIORAL; Name: Educational Reminder; Assigned to Arm(s): Control, Intervention

Answer: C