Article Figures & Data
Figures
- Figure 1. Flow diagram of the study and its participating health centres
- Figure 2. Number of ordered vitamin tests in pre-intervention period (in quartiles) related to reduction in number of ordered tests during intervention period. pts = patients.
Tables
- Table 1. Baseline characteristics of participating GPs, including pre-intervention numbers of vitamin testing
Characteristic Total Intervention group Strategy 1(GP only) Strategy 2(GP and patient) P value Health centres, n 26 13 13 GPs,n 158 78 80 0.85 Male, n (%) 47 (30) 25 (32) 22 (28) 0.72 Population, n 195 394 97 658 97 736 0.99 SES, mean (range)a 0.26(−2.58–2.06) 0.53(−2.40–2.06) 0.21(−2.58–1.66) 0.48 Vitamin D tests pre-intervention, n 17 527 10 277 7250 0.30 Vitamin D/1000 patients pre-intervention, n (range) 88
(12–262)102
(32–262)75(12–150) 0.22 Vitamin B12 tests pre-intervention, n 12 304 7242 5062 0.36 Vitamin B12/1000 patients pre-intervention, n (range) 59
(7–198)b69
(7–198)49
(15–156)0.21 GPs who followed e-learning, n (%) 76 (48) 28 (36) 48 (60) 0.11 GPs present at first training session, n (%) 50 (32) 26 (33) 24 (30) 0.86 GPs present at second training session, n (%) 50 (32) 24 (31) 26 (33) 0.85 aSES data, linked by four digital postal codes to location of health centre.17 bMean difference Utrecht-Rotterdam = –60 (95% CI = –94 to –26), P = 0.06. SES = socioeconomic status.
Characteristic Total De-implementation strategy Strategy 1 (GP only) Strategy 2 (GP and patient) Health centres, n 26 13 13 Vitamin D Reduction, % (range) 23(−9–70) 19(−4–70) 29(−9–28) Absolute reduction in vitamin D/1000 patients, mean (range) 22 (−6–98) 24 (−6–98) 21 (−6–51) Vitamin B12 Reduction, % (range) 20(−19–63) 18(−3–63) 22(−19–42) Absolute reduction in vitamin B12/1000 patients, mean (range) 12 (−6–69) 15 (−3–69) 9 (−6–63) Vitamin D Vitamin B12 Pre-intervention year Intervention year Pre-intervention year Intervention year Average value (range) 56 nmol/L (5–327) 55 nmol/L (10–309) 304 pmol/L(34–1476) 304 pmol/L(36–1476) Female patients, % 72 72 72 72 Age, years, mean (SD) 48 (20) 47 (20) 51 (21) 50 (20) Reference value: % <50 nmol/L if >70 years: 30<30 nmol/L if <70 years: 17 <50 nmol/L if >70 years: 32<30 nmol/L if <70 years: 18 <148 pmol/l: 17 <148 pmol/L: 16 SD = standard deviation.
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Effectiveness of professional and patient-oriented strategies in reducing vitamin D and B12 test ordering in primary care: a cluster randomised intervention study
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