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Addressing barriers to change: an RCT of practice-based education to improve the management of hypertension in the elderly.

Cranney M, Barton S and Walley T (1999) British Journal of General Practice, 49: 522–526.



Method A randomised, single-blind, controlled trial of incorporating an exploration of barriers to changing practice into an educational strategy for GPs was conducted in 18 practices. Both groups of practices received visits during which they received the results of a previous audit on the management of hypertension in the elderly. The nine intervention practices were encouraged to explore barriers that would prevent them from implementing the pertinent research findings, in addition to an exploration of the issues and creation of a practice action plan. Control groups received the education without the element of exploring barriers to change. The outcome measures were changes in response to a questionnaire before and after the educational intervention.

Results There were statistically significant differences between the two groups after the educational visit. Those practices who were encouraged to explore barriers to change were more likely to show change in behaviour compared to the control group. All the intervention practices produced an action plan for improving the performance, whereas none of the controls did so. The intervention practices also showed more concordance in management protocols after the intervention.

Conclusion Addressing the barriers preventing practitioners from implementing research findings is effective in implementing change.