Effects of distance learning on clinical management of LUTS in primary care: a randomised trial

Patient Educ Couns. 2005 Nov;59(2):212-8. doi: 10.1016/j.pec.2004.11.009. Epub 2004 Dec 30.


Aim: To determine the effect of a distance learning programme on general practice management of men with lower urinary tract symptoms (LUTS).

Methods: A cluster randomised controlled trial was performed. General practitioners (GPs) were randomised to a distance learning programme accompanied with educational materials or to a control group only receiving mailed clinical guidelines on LUTS. Clinical management was considered as outcome.

Results: Sixty-three GPs registered care management of 187 patients older than 50 years attending the practice because of LUTS. The intervention group showed a lower referral rate to a urologist (OR: 0.08 (95% CI: 0.02-0.40)), but no effect on PSA testing or prescription of medication. PSA testing tended to be requested more frequently by intervention group GPs. Secondary analysis showed patients in the intervention group received more educational materials (OR: 75.6 (95% CI: 13.60-419.90)).

Conclusions: The educational programme had impact on clinical management without changing PSA testing. Distance learning is an promising method for continuing education.

Practice implications: Activating distance learning packages are a potentially effective method for improving professional performance. Emotional matters as PSA testing probably need a more complex approach.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Competence / standards*
  • Cluster Analysis
  • Decision Trees
  • Education, Distance / organization & administration*
  • Education, Medical, Continuing / organization & administration*
  • Family Practice / education
  • Family Practice / methods
  • Family Practice / standards
  • Female
  • Guideline Adherence / standards
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Netherlands
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / standards
  • Primary Health Care / methods*
  • Primary Health Care / standards
  • Program Evaluation
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / diagnosis*
  • Urination Disorders / etiology


  • Prostate-Specific Antigen