The 12 remaining studies across all musculoskeletal conditions showed little or no improvement in GP behaviour and patient outcomes .The direction of the targeted behaviour ( i.e. increasing or decreasing a behaviour ) does not seem to affect the effectiveness of an intervention .
There is good- quality evidence that a GP alerting system with or without patient-directed education on osteoporosis improves guideline -consistent GP behaviour , result ing in better diagnosis and treatment rates .
Interventions such as GP reminder messages and GP feedback on performance combined with guideline dissemination may lead to small improvements in guideline -consistent GP behaviour with regard to low back pain , while GP education on osteoarthritis pain and the use of educationally influential physicians may lead to slight improvement in patient outcomes and guideline -consistent behaviour respectively .
BACKGROUND Musculoskeletal conditions require particular management skills .
Identification of interventions which are effective in equipping general practitioners ( GPs ) with such necessary skills could translate to improved health outcomes for patients and reduced healthcare and societal costs .
OBJECTIVES To determine the effectiveness of professional interventions for GPs  that aim to improve the management of musculoskeletal conditions in primary care .
We investigated whether the direction of the targeted behavioural change affects the effectiveness of interventions .
Effectiveness of a learner-centred training programme for primary care physicians in using a patient-centred consultation style.
OBJECTIVE The aim of the present study was to find out if a training programme adapted to family physicians with several years of clinical experience changes their behaviour when they deal with fibromyalgic patients in the sense of introducing the communication skills that define the ' patient-centred ' approach . METHODS A r and omized , and simple blind , educative study was carried out . Twenty full-time family physicians were invited to participate . They were allocated r and omly to two groups : an intervention and a control group . A total of 110 patients were recruited from people attending physicians ' surgeries for the first time and who complained of generalized pain that finally fulfilled criteria for generalized musculoskeletal chronic pain/fibromyalgia . This was done for an entire year . The intervention group received an 18 hour intensive course . One week after the course , all doctors carried out a video-recorded encounter with a patient who played the part of a typical fibromyalgia clinical case . The interviews were coded by an observer blind to the training status of the participants , using the GATHARES-CP question naire . All patients were contacted by telephone during a 1 - 2-month period by a different interviewer who was ' blinded ' to the patient 's experimental status . They were asked to respond to three questions that represent the key components of patient-centred style . RESULTS The average score on the GATHARES-CP question naire was 11.3 + /- 0.9 and 9 + /- 2.3 , for doctors from the intervention and control groups , respectively ( P < 0.01 ) . For 11 items , scores were higher in the intervention group . The patients ' answers to all three questions showed statistically significant differences in a positive direction for the trained doctors . CONCLUSIONS The doctors improved the use of strategies and skills for carrying out patient-centred consultations after they had received an interactive course . The doctors ' behaviour appeared to have changed as much in a more experimental situation as in the actual consultations . Moreover , the gain was observed immediately after the intervention was completed , and after having run for a variable period of time up to 1 year
The 12 remaining studies across all musculoskeletal conditions showed little or no improvement in GP behaviour and patient outcomes .The direction of the targeted behaviour ( i.e. increasing or decreasing a behaviour ) does not seem to affect the effectiveness of an intervention .
There is good- quality evidence that a GP alerting system with or without patient-directed education on osteoporosis improves guideline -consistent GP behaviour , result ing in better diagnosis and treatment rates .
Interventions such as GP reminder messages and GP feedback on performance combined with guideline dissemination may lead to small improvements in guideline -consistent GP behaviour with regard to low back pain , while GP education on osteoarthritis pain and the use of educationally influential physicians may lead to slight improvement in patient outcomes and guideline -consistent behaviour respectively .
BACKGROUND Musculoskeletal conditions require particular management skills .
Identification of interventions which are effective in equipping general practitioners ( GPs ) with such necessary skills could translate to improved health outcomes for patients and reduced healthcare and societal costs .
OBJECTIVES To determine the effectiveness of professional interventions for GPs  that aim to improve the management of musculoskeletal conditions in primary care .
We investigated whether the direction of the targeted behavioural change affects the effectiveness of interventions .