The Center for Studying Health System Change recently issued research that shows primary care physicians still prefer using educational pamphlets to inform patients about their chronic conditions, despite the availability of other care management tools.

“The higher use of written patient education materials may reflect expediency rather than effectiveness—if you’re a busy physician, giving an educational pamphlet to your patient is quick and easy. But most researchers think it’s less powerful than other, more demanding interventions we found were used much less often,” explains HSC senior researcher Emily Carrier.

The study found that practice size and setting played a key factor in determining which care management tools physicians used. For example, solo and smaller group practices are less likely to use care management tools, HCS reports.

Care management tools included written materials for patient education, nurse managers to coordinate care, non-physician educators and group visits. In addition, HSC researchers asked doctors whether they used reports to track the quality of preventive care they deliver and patient registries.

The research, which was funded by the Robert Wood Johnson Foundation, represented a subsample of 1,304 physicians who practiced primary care medicine. In 2008, 91% of physicians with primary care practices treated patients with asthma, diabetes, congestive heart failure and depression.

The study findings show that three-quarters of physicians offered patients written educational materials, while only half used non-physician educators, one-third utilized nurse managers to coordinate care and one-fifth provided group visits.

“The findings suggest that, along with experimenting with financial incentives for primary care physicians to adopt care management tools, policy makers might consider developing community-level resources—such as nurse managers—that could be shared among smaller practices,” says Carrier, coauthor of the study.

Other key findings include:

• About two-thirds of physicians noted receiving reports on the quality of their preventive and chronic care, and 40% used registries to identify patients with specific chronic conditions.

• Overall, 47% of physicians were in practices that used two or fewer of the seven care management tools, and 4% were in practices using six or seven care management tools.

• Physicians in group- or staff-model health maintenance organizations were the most likely to use all of the care management tools. For example, about one in 10 physicians in solo or two-physician practices reported using group visits, compared with about three in 10 physicians in group practices of 50 or more physicians, and about seven in 10 physicians in group/staff-model HMOs.

• Eighty-six percent of physicians in group/staff HMOs received both types of feedback reports, compared with physicians in solo or two-physician practices where 63% received reports on preventive care and 67% received reports on chronic care.

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