Long-term effects of an education programme on the optimal use of clinical chemistry testing in primary health care

Objective: The aim of this study was to investigate whether continuing education on the optimal use of clinical chemistry testing in primary health care has had any long-term effects on the test-ordering behaviour of the participating physicians. Methods: The effects were monitored using 12 laboratory test ratios. Twenty-three general practitioners at 16 primary health-care centres in the county of Uppsala, Sweden, participated. A sign test was used to evaluate how individual physicians' test-ordering patterns have changed during the 8 years since implementation of the educational programme. Maintained or improved ratios were interpreted as a sustained effect on the primary health-care physician's test-ordering habits. Results: Eleven out of 12 of the investigated ratios were the same or improved since the time of the short-term follow-up 6 months after the education. Conclusion: A short continuation course on optimal use of clinical chemistry assays can achieve permanent changes in the test-ordering patterns of primary health-care physicians. These findings highlight education as one possible means towards achieving cost-efficiency and quality in test-ordering.