Table 4

Studies testing consistently ongoing implementation interventions

StudyIntervention and controlOutcome measuresResultsSuccess
Eccles et al., 2001 [24]IG1: A&F: − audit and feedback
IG2: ER - educational reminders
IG3: A&F + ER – both interventions. All IGs also received a copy of guidelines
CG: Copy of the guidelines only
Primary outcome measure:
Radiograph request rate.
−1.53 absolute reduction per 1000 patients ER (95 % CI −2.5 to −0.57) v CG
ρ values not stated
−0.70 A&F (95 % CI −1.3 to 0.9) v CG
ρ values not stated
No increased effect A&E + ER.
Successful. Statistically significant differences in lumbar spine radiograph request rate between groups

Ramsey et al., 2003 [48]IG: Educational reminders
CG: Copy of guidelines only
Primary outcome measure:
Monthly radiograph request rate for 12 months
Practice mean per month: 1.76 IG v 2.38 CG
ρ values not stated
0.64 relative risk (95 % CI 0.43 to 0.96) IG
ρ = 0.029*
Successful. Statistically significant differences between groups and no decay of effect over 12 months.

Baker et al., 1987 [50]IG: Special radiographic requisition form
CG: None as a ITS
Primary outcome measure:
Radiographic request rate.
Reduction of radiograph request rate from 1443 to 759
ρ values not stated
Successful. A 47 % reduction in the first year maintained for next 3 years

McGuirk et al., 2001 [32]IG: Special evidence based clinics staffed by motivated practitioners
CG: Usual care
Primary outcome measures:At 3 months:At 6 months:At 12 months:Partially successful. The differences in the VAS at 3 and 12 months were statistically significantly different. The difference between groups in the SF-36 physical functioning at 12 months was statistically ignificantly different.
None of these differences in the SF-36 social functioning or physical role were statistically significantly different between groups.
The differences in the SF-36 bodily pain at 3 and 6 months were statistically significantly different between groups.
1. Pain VAS2 IG v10 CG
ρ = 0.001*
3 IG v 4 CG
ρ = 0.21
2 IG v 9 CG
ρ = 0.042*
2. SF-36 physical functioning1.02 IG v 1.00 CG
ρ = 0.364
1.04 IG v 1.04 CG
ρ = 0.197
1.07 IG v 0.91 CG
ρ = 0.006*
2. SF-36 social functioning1.14 IG v 1.13 CG
ρ = 0.853
1.15 IG v 1.13 CG
ρ = 0.269
1.15 IG v 1.15 CG
ρ = 0.888
2. SF-36 physical role1.17 IG v 1.12 CG
ρ = 0.939
1.17 IG v 1.12 CG
ρ = 0.35
1.18 IG v 1.12 CG
ρ = 0.782
2. SF-36 Bodily pain0.93 IG v 0.79 CG
ρ = 0.027*
1.01 IG v 0.90 CG
ρ = 0.018*
1.02 IG v 0.90 CG
ρ = 0.123
Abbreviations: A&F Audit and feedback group, A&F + ER audit and feedback and educational reminders group, CG control group, ER Educational reminders group, HCP healthcare practitioners, IG intervention group, ITS interrupted time series, VAS visual analogue scale