One-to-one versus group sessions to improve prescription in primary care: a pragmatic randomized controlled trial

Med Care. 2001 Feb;39(2):158-67. doi: 10.1097/00005650-200102000-00006.


Objectives: The objective of the study was to evaluate the effectiveness of 2 educational strategies aimed at improving prescribing standards in primary care.

Methods: A pragmatic controlled trial was designed; the study population included general and family practitioners in Galicia (northwestern Spain) divided into 3 study groups: a one-to-one education group (n = 98), a by-group education group (n = 92), and a control group (n = 405). The educational intervention included explicit recommendations for selecting nonsteroidal anti-inflammatory drugs (NSAIDs) for inflammation signs. Some of the subjects were given reminders. Mixed-effect linear models were applied to data analysis. Analyses were done by intention-to-treat. The dependent variable is a rate with a numerator that is the number of prescribed units of the NSAIDs recommended during intervention; the denominator is the total number of prescribed units of the NSAID total.

Results: One-to-one education obtained an average prescribing behavior improvement of 6.5% (P < 0.001) in the 9 months after intervention. In the education group, the average improvement was 2.4% (P < 0.05) for the same period. Statistically significant differences were observed between the group intervention and one-to-one groups. The reminder increased significantly the effectiveness of the one-to-one intervention.

Conclusions: A single, short educational session to primary care doctors can improve their prescribing standards during long periods of > or = 9 months. Of the 2 strategies followed in the trial, one-to-one education has shown to be the most effective. Results also show that the effectiveness of these interventions increases when presented together with written material.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Drug Prescriptions / standards
  • Drug Utilization / standards*
  • Education, Medical, Continuing / methods*
  • Group Processes
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Physicians, Family / education*
  • Physicians, Family / psychology
  • Practice Patterns, Physicians' / standards*
  • Primary Health Care / standards*
  • Spain
  • Teaching / methods*
  • Teaching Materials
  • Time Factors
  • Total Quality Management / organization & administration*


  • Anti-Inflammatory Agents, Non-Steroidal