Research on changing practitioner and patient behavior

The Institute of Medicine's report "Crossing the Quality Chasm" (2001) indicates that it takes 17 years, on average, for knowledge generated by randomized trials to be adopted in practice if there is no effective intervention in place to promote the evidence. Influencing provider behavior is a formidable task, and many strategies traditionally used, such as unsolicited distribution of consensus recommendations or guidelines, and traditional didactic lectures and seminars, have generally been proven to be ineffective in changing clinical practices. The summaries that follow provide an overview of recently published, research-based works on strategies to change clinician and/or patient behavior. Two articles focus on improving hypertension management and two focus on improving heart failure management, conditions that are seen at very high levels in home care. We hope that the following summaries will stimulate some thinking about strategies that can be tried in home care organizations to promote the adoption of evidence-based care. For additional details about the intervention and research findings, we suggest that our readers refer to the original articles.