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 .
General practitioners' use of magnetic resonance imaging: an open randomized trial comparing telephone and written requests and an open randomized controlled trial of different methods of local guideline dissemination.
AIM To determine the impact and cost-effectiveness of telephone versus written access to magnetic resonance imaging ( MRI ) , and of different strategies for disseminating locally produced guidelines , upon requests by general practitioners ( GPs ) for knee and lumbar spine investigation . MATERIAL AND METHODS Two sequential pragmatic open cluster-r and omized trials were conducted within 39 general practice s. The outcome measure in each trial was concordance of request with local guidelines . Trial 1 : practice s requested MRI by telephone or in writing . Trial 2 : all practice s received guidelines , plus either : a practice -based seminar , practice -specific audit feedback , both seminar and feedback , or neither . RESULTS A total of 414 requests were assessed in the two trials . Trial 1 : telephone access  cost pound4.86 more per request but rates of concordant requests were equivalent ( 65%/64 % : telephone/written ) . Trial 2 : compared to the control group , costs per practice were pound1911 higher in seminar group , pound1543 higher in feedback group and pound3578 higher for those receiving both . Concordance was greater following the intervention ( 74 % vs 65 % ; P < 0.05 ) , but there was no difference between the four study groups . CONCLUSIONS Method of access did not affect concordance . Written access was more cost-effective . Seminars and feedback were no more effective in modifying practice than guidelines alone , which was thus the most cost-effective option
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 .