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Influence of discipline of provider and model of care on an arthritis educational intervention in primary care
Author(s) -
Lineker Sydney C.,
Husted Janice A.,
Brown K. Stephen
Publication year - 2012
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.20694
Subject(s) - medicine , multidisciplinary approach , intervention (counseling) , physical therapy , family medicine , rehabilitation , baseline (sea) , best practice , medline , nursing , social science , oceanography , management , sociology , geology , political science , law , economics
Abstract Objective To identify both provider and organizational characteristics that predicted outcomes following an educational intervention (9‐hour workshop and followup reinforcement activities) developed to improve the management of arthritis in primary care. Methods Providers completed a survey at baseline and at 6 months postworkshop, including a case scenario for early rheumatoid arthritis. Providers were asked how they would manage the case and their responses were coded to calculate a best practice score, ranging from 0–7. Two‐level hierarchical linear modeling was used to determine which of the measured provider and organizational factors predicted best practice scores at followup. Results A total of 275 multidisciplinary providers from 131 organizations completed both baseline and followup surveys. Best practice scores increased by 17% ( P < 0.01); however, the mean score at 6‐month followup remained relatively low (2.68). Significant predictors of best practice scores at followup were discipline of provider and model of primary care in which they worked ( P < 0.05), adjusting for baseline practice scores and clustering of providers within organizations. Physicians, nurse practitioners, and rehabilitation therapists scored higher than nurses, students, and other health care providers ( P < 0.01). Physician networks scored significantly lower than providers from multidisciplinary‐oriented models of care ( P = 0.02). Conclusion These results have implications for the education of health professionals and the design of models of care to enhance arthritis care delivery.