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Biomedical subjects

O E Laxdal

Publications and source records attributed to O E Laxdal.

14 recordsLinked to original sources
PubMed1991

Physician management of hyperlipidemia in Saskatchewan: temporal trends and the effect of a CME program.

OBJECTIVE: To assess current trends in the management of hyperlipidemia by Saskatchewan physicians, and to evaluate the effect of a specific continuing medical education (CME) program. DESIGN: Using a quasi-experimental design, physicians in an intervention area received the CME program while those in a comparison area did not. Management of hyperlipidemia was assessed before and after the program via a self-administered questionnaire. SETTING: All family physicians, general internists and cardiologists practising in the two areas were eligible. SUBJECTS: Of 439 eligible physicians, 308 (70%) completed the first survey, while 268 of 447 (60%) completed the second survey. Analysis was conducted on the 221 physicians who completed both surveys. INTERVENTION: Physicians in the intervention area received printed materials and attended a series of seminars between November 1988 and February 1989. Program content was based upon the recommendations of the Canadian Consensus Conference on Cholesterol (1988). MAIN RESULTS: Over the study period the mean level of serum cholesterol considered 'ideal' for a 40- to 60-year-old male decreased significantly from 5.43 to 5.03 mmol/L (P less than 0.001). The mean level at which diet therapy was begun decreased from 6.60 to 5.78 mmol/L (P less than 0.001) with a significantly greater proportion of physicians in the intervention area (58.0%) than in the comparison area (43.2%) initiating therapy in the 5.2 to 5.6 mmol/L range (P = 0.03). The mean level of serum cholesterol at which drug therapy is begun also decreased from 7.59 to 6.82 mmol/L (P less than 0.001), with a significantly greater proportion of physicians in the intervention (41.6%) than in the comparison area (25.0%) starting therapy in the 6.2 to 6.6 mmol/L range (P = 0.03). CONCLUSIONS: The management of hyperlipidemia reported by physicians in Saskatchewan changed dramatically between July 1988 and March 1989. The effect of the CME program is modest in comparison with this large temporal trend. The study provides further evidence that significant changes in the practice patterns of groups of physicians will only occur when the educational process is highly focused and personalized.

Adult↗
PubMed1988

The effects of continuing medical education on family doctor performance in office practice: a randomized control study.

A randomized controlled study was conducted to determine if specifically designed continuing medical education in the fields of cardiovascular and cancer medicine could change doctor office behaviour significantly. Thirty-one volunteer family doctors from 25 offices participated. Six (three cardiovascular and three cancer) learning objectives were defined. Two educational formats were selected as the independent variables: (1) group interaction opportunities (face-to-face and teleconference); and (2) concisely written newsletters. Chart measures of doctor performance prior to and 6 and 12 months following education served as the dependent variables. The family doctors receiving education were found to perform the recommended behaviours significantly more than those who did not receive the education (P less than 0.05) at 6 months post-education. This difference was maintained at the 12-month post-educational period for one of the educational programmes offered. A carefully planned programme of continuing medical education will result in favourable changes in the office practice of volunteer doctors. These changes can persist for as long as 12 months. Adherence to several essential learning principles is required.

Cardiology↗
PubMed1984

Designing education interventions to improve physician performance in office practice.

Family doctors play a very important role in determining the health of the populace; however, surveys and expert opinions indicate that there is considerable room for improvement in the knowledge and skills of family physicians concerning the prevention, early detection and management of the major causes of death and disability. Effective Continuing Medical Education (CME) could help greatly to resolve this problem. THere is, however, little evidence that presently available systems of CME, though costly, are effective in improving either physician competence or patient health. Attractive and cost-effective CME methods are greatly needed. This study develops, field tests and evaluates more efficient office-based CME programs for family doctors. Prevention, early detection and improved management of cardiovascular disease and cancer are the primary goals. A pretest posttest control group and time series approach was chosen for the experimental design. Thirty-one family physicians are participating. Physician performance and patient outcome prior to and after education are being assessed largely through office record review.

Education, Medical, Continuing↗
PubMed1982

Needs assessment in continuing medical education: a practical guide.

The identification and assessment of learning needs and the setting of priorities are the foundation of successful program planning in continuing medical education (CME). The present report includes recommendations concerning optimal procedures for the assessment of the learning needs of individual physicians, small groups, and large groups. The vital role of learners and their perceived needs in emphasized. Appropriate and accurate needs assessment contributes greatly to the success of CME programs. The most effective needs assessment involves the dynamic interaction of teachers, learners, and experienced program planners. The recommendations in this report are based on studies and interviews conducted in several major academic health centers in the United States and Europe over a period of one year. Research efforts to improve needs assessment techniques are greatly needed. As improved methods of needs assessment are adopted, CME planners may be assured that their programs will become more attractive and effective.

Clinical Competence↗
PubMed1978

Improving physician performance by continuing medical education.

In 1973 the division of continuing medical education of the University of Saskatchewan initiated a 3-year study to determine the effect of hospital-based education on the prescribing accuracy of physicians. This study was undertaken in response to an urgent need to develop more effective methods of continuing medical education and improved techniques of measuring their effectiveness. The educational program focused on common prescribing problems that had previously been defined by experts in the field. Problem frequency was determined by the monitoring of hospital records prior to institution of the educational program and at 3, 6 and 12 months after the program had concluded; this was found to be a satisfactory method of identifying educational needs and is considered to provide a measure of the quality of medical care. Fifteen physicians at three rural hospitals participated in the study. Seventeen physicians at two similar hospitals served as controls. The average problem frequency for topics selected at the study hospitals was reduced by 63% (the percentage of possible improvement), whereas at the control hospitals the frequency of the same problems declined by 32% over the same period. The results of this study provide evidence that an intensive, problem-based program on therapeutics can improve physician performance.

Drug Prescriptions↗
PubMed1976

Saskatchewan dial-access drug information service.

In September 1974 the colleges of pharmacy and medicine of the University of Saskatchewan began offering a drug information service to the pharmacists and physicians of Saskatchewan without charge. With the help of a radio-page system, calls are taken immediately by experienced pharmacists and pharmacologists. The cost of long-distance phone calls is borne by grants from the Saskatchewan medical and pharmaceutical associations. During the 1st year of operation 415 requests for information were received. Of 93 persons who called up to Feb. 28, 1975, 76% responded to an evaluation questionnaire; virtually all described the service as very valuable. The information received resulted in the alteration of drug therapy in one third of calls requesting information to assist in current treatment of a patient.

Drug Information Services↗
PubMed1975

POGO '75.

Explore the source record for details and available documents.

Canada↗
PubMed1970

Treatment of acute otitis media: a controlled study of 142 children.

Results of the use of ampicillin, penicillin G and symptomatic therapy in the treatment of acute otitis media in 142 children were compared. Antibiotic therapy conveyed significant benefit. No major differences were observed between penicillin and ampicillin, except in the age group under 3 years where ampicillin was associated with the best results. Ampicillin appears to be the drug of choice. Its superiority over symptomatic therapy was statistically significant. Long-term sequelae were not observed in any of the three treatment groups. The relative merits of erythromycin and ampicillin require further study.

Acute Disease↗
PubMed1966

Etiology of acute otitis media in infants and children.

Seventy-one children were studied intensively in an attempt to identify both bacterial and viral agents responsible for acute otitis media. Studies included processing of nasopharyngeal secretions and of fluid obtained by needle aspiration of the middle ear. Ear fluid was consistently sterile for viruses but grew bacterial pathogens in 10 of 20 specimens. Nose and throat cultures yielded bacterial pathogens in less than 40% and were of little value in predicting middle-ear flora. Influenza C was isolated from one of 48 throat washings. Viral serology was compatible with influenza A2 and adenovirus infection in two cases. Bacterial and viral agents could not be incriminated in nearly 50% of the children studied.

Adenoviridae↗
PubMedDate not supplied

Desirable behaviours in the office management of hypertension addressed through continuing medical education.

Twenty family physicians in Saskatchewan participated in this randomized controlled study which examined the effects of relatively low-cost educational techniques on the office management of hypertension. We measured 1,538 episodes of care relating to the office management of hypertension by chart review, prior to, and at six and 12 months following education. The family physicians who participated in the education were found to perform the recommended behaviours significantly more often at six and 12 months post education than those physicians who did not have the education. Our findings indicate that carefully planned, inexpensive educational techniques can improve clinical behaviour in areas where there is identified educational need.

Behavior↗