Spreading Medical Knowledge

An article in Health Affairs discusses an important issue in regard to comparative effectiveness research, and indeed, all medical research.  The issue is ensuring the dissemination and use of the results in daily clinical practice by physicians and other health professionals treating patients.  (HA Article) The premise behind comparative effectiveness research is that it will ultimately change medical practices in a manner that improves quality and that may also lower costs, at least in the long run.  Inappropriate or useless treatments should become less common.  For this to be true, however, doctors have to actually know about the results and incorporate them into how they handle patients’ needs.

Given the stress and time pressure of most physicians’ daily routines, that is no simple task.  As the authors note, often even the most basic, highly validated treatment guidelines are ignored.  Some reasons for the difficulty of getting recommendations into use include lack of effective dissemination methods; uneven quality of continuing medical education efforts, many of which are sponsored by manufacturers; marketing programs by manufacturers which misrepresent or obscure the research results; and physician resistance to change.

The authors suggest that some remedies for the problem might include planning ahead of the result’s release so they can optimally be transmitted to doctors; improving continuing health professional education; greater use of health information technology such as clinical decision support systems; and implementation of reward systems for providers who keep up with and implement research results.  The authors have clearly identified and addressed a critical roadblock to improving quality and more attention should be paid to this issue.