Reducing the prescribing of heavily marketed medications: a randomized controlled trial.

Context: Prescription drug costs are a major component of health care expenditures, yet resources to support evidence-based prescribing are not widely available.

Objective: To evaluate the effectiveness of computerized prescribing alerts, with or without physician-led group educational sessions, to reduce the prescribing of heavily marketed hypnotic medications.

Design: Cluster-randomized controlled trial.

Physician responses to a community-level trial promoting judicious antibiotic use.

Purpose: In an environment of multiple campaigns promoting judicious antibiotic use in children, identification of effective strategies is important. We assessed physician responses to a community-level intervention with respect to antibiotic prescribing, related practices, and perceived effectiveness.

Methods: This study was a mixed qualitative and quantitative evaluation of a randomized controlled community-wide educational intervention in 16 Massachusetts communities.

Parental knowledge about antibiotic use: results of a cluster-randomized, multicommunity intervention.

Objective: The goal was to determine the impact of a community-wide educational intervention on parental misconceptions likely contributing to pediatric antibiotic overprescribing.

Methods: We conducted a cluster-randomized trial of a 3-year, community-wide, educational intervention directed at parents of children < 6 years of age in 16 Massachusetts communities to improve parental antibiotic knowledge and attitudes and to decrease unnecessary prescribing. Parents in 8 intervention communities were mailed educational newsletters and exposed to educational materials during visits to local pediatric providers, pharmacies, and child care centers.

Preparing faculty to teach managing care competencies: lessons learned from a national faculty development program.

Background: Although competencies for managing care are often described in the medical literature, educators have been slow to integrate these competencies into clinical curricula. Backlash against managed care has created a skeptical educational environment. Many faculty feel unprepared to teach the competencies in clinical settings.

Geriatrics training in general internal medicine fellowship programs: current practice, barriers, and strategies for improvement.

To ensure its growth and prosperity, general internal medicine will need to embrace care of the elderly, research on aging, and geriatrics education as components of its core mission. Experts agree that general internal medicine fellows could benefit from increased opportunities in research on aging and geriatrics education; however, important barriers will hamper efforts to integrate geriatrics training into general internal medicine fellowship programs. This article reviews the barriers to integration and proposes solutions for overcoming those barriers.

Evaluation of a faculty development program in managing care.

Purpose: To evaluate a faculty development program that teaches quality improvement and cost-effectiveness.

Method: From October 2000 to February 2001, a two-part faculty development program was offered to 39 physicians from 19 U.S.