Background: Clinical Practice Guidelines are made to help practitioners in decision making towards improving appropriateness of care. However, successful implementation strategies are still lacking. Patient mediated intervention as away of CPG implementation is being recommended.

Methods: This study is a three-phase, randomized controlled trial. Following a 3-month baseline period, a one-hour interactive lecture on guideline recommendations was conducted among family medicine residents. After 3 months, clinic days were randomized to days with and days without public health lecture. A one-hour interactive lecture on the recommendations on sinusitis and rhinitis was conducted on patients at the out-patient waiting area on pre-selected days. Appropriateness of care by chart audit was done at every phase.

Results: Baseline appropriateness of care was low at 10.8 percent on history taking and physical examination, 56.8 percent on request for diagnostics, 75.7 percent on antibiotic prescription, 48.6 percent on overall treatment. Referrals at baseline were appropriately high at 94.6 percent. Interactive lecture did not increase appropriateness of care. The addition of public health lecture significantly increased appropriateness in history taking and physical examination to 25.9 percent, and request of diagnostics to 70.6 percent. No change noted on antibiotic prescription at 41.2 percent, overall treatment at 41.2 percent and referrals at 88.2 percent.

Conclusions: The addition of public health lecture to interactive lecture was effective in increasing appropriateness of care in history and physical examination and request of diagnostics.

Objectives
To determine the effectiveness of public health lecture to patients combined with interactive lecture on physicians regarding guidelines for rhinitis and sinusitis in improving appropriateness of care compared with interactive lecture alone.

The Filipino Family Physician, 2001 39 ( 3 ) pages 69-73