An educational program for physicians on syncope management did not significantly reduce the use of neurological investigations in discharged (8% vs 11%, NS) or hospitalized patients (48% vs 48%).
Observational (n=978)
Does an educational program for physicians reduce the use of unnecessary neurological investigations in patients presenting with syncope?
Education of physicians alone is inadequate to improve guideline adherence and reduce unnecessary neurological investigations in the emergency management of syncope.
Absolute Event Rate: 8% vs 11%
p-value: p=NS
AIM: Management of patients (pts) presenting syncope diverges markedly from the guidelines of the European Society of Cardiology (ESC). To improve this management, the easiest option seemed to be to educate physicians. The aim of the study was to evaluate the impact of an educational process on the use of unnecessary neurological investigations. METHODS AND RESULTS: Charts of pts presenting syncope during two 12-month periods (1999-2000 and 2002-2003) to the emergency department were systematically reviewed. Between the two periods, all physicians in charge of pts with syncope attended educational meetings. During these meetings recommendations of the ESC were presented with a special emphasis on the uselessness of neurological investigations. Four hundred and fifty-four pts (1.2%) presented to the emergency department for syncope during study period 1, and 524 (1.3%) during study period 2. Nineteen of the 169 pts (11%) directly discharged from the emergency department, had neurological investigations during study period 1 and 22 of the 279 (8%) during study period 2 (NS). In pts who were hospitalized, 48% had neurological investigations in groups 1 and 2. CONCLUSION: Education of physicians in charge of patients with syncope is inadequate to improve the cost effectiveness of the management of these patients.
Blanc et al. (Sat,) conducted a observational in Syncope (n=978). Educational meetings for physicians on ESC guidelines vs. Pre-educational period (standard practice) was evaluated on Use of neurological investigations in patients directly discharged from the emergency department (p=NS). An educational program for physicians on syncope management did not significantly reduce the use of neurological investigations in discharged (8% vs 11%, NS) or hospitalized patients (48% vs 48%).