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 .
Effects of training on general practitioners' management of pain in osteoarthritis: a randomized multicenter study.
OBJECTIVE To evaluate the effects of a short interactive training program for general practitioners ( GP ) on pain management in patients with osteoarthritis ( OA ) . METHODS A multicenter , parallel-group study . GP were r and omized to receive training on relationships and communication , pain evaluation , prescription , and negotiation of a patient contract or to a control group receiving a presentation about obtaining consent in trials . Outcomes were patient assessment s of pain and functional ability . We invited 1500 GP to take part in the study . Those who volunteered to receive the training recruited out patients from May 2001 to April 2002 . Patients participating in the evaluation of the effects of the general practitioners ' training had lower limb OA and pain on motion [ > or = 40 mm on a visual analog scale ( VAS ) ] and had indications for treatment with acetaminophen . The primary endpoint : sum of patient pain relief based on the daily VAS self-evaluation during the 2 weeks of the trial . RESULTS In total , 180 GP ( 84 trained , 96 nontrained ) enrolled 842 patients ( 414 and 428 , respectively ) . Mean baseline VAS pain was 63 + /- 14 mm . Patients in the trained-GP group had better overall pain relief ( 316 + /- 290 mm/day vs 265 + /- 243 mm ; p < 0.0001 ) , greater improvement in Lequesne and WOMAC scores ( p < 0.0001 ) , and better overall perception of treatment ( p = 0.002 ) .  Acetaminophen use was slightly higher in the trained group ; however , the difference in pain relief remained statistically significant ( p = 0.0003 ) after adjustment for this difference . CONCLUSION This is the first study to demonstrate a positive effect of physician training on patients with a painful condition
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 .