Local opinion leaders: Effects on professional practice and health care outcomes

by admin admin | Mar 01, 2008
Summary of a systematic review by G. Doumit, M. Gattellari, J. Grimshaw, and M.A. O'Brien, in the Cochrane database of systematic reviews in 2007.
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KEY MESSAGES

  • Opinion leaders disseminating and implementing "best evidence" is one innovative method that holds promise as a strategy to bridge know-do gaps.
  • When it comes to encouraging change, opinion leaders' views have greater sway than other people's constructive criticism.
  • Identifying opinion leaders can take a lot of work and be hard to validate, but when they are found they can boost the amount of research being used in everyday practice.

This is a summary of a systematic review by G. Doumit, M. Gattellari, J. Grimshaw, and M.A. O'Brien, published in the Cochrane database of systematic reviews in 2007.

For healthcare professionals it is difficult to integrate research evidence into everyday practice. While there is certainly interest in devising innovative methods to promote the use of evidence in clinical practice, being faced with dozens, even hundreds of treatment decisions a day means the translation of evidence can be slow, unpredictable and incomplete.

However, according to "Local opinion leaders: Effects on professional practice and health care outcomes," one way to encourage the greater use of research evidence among healthcare practitioners is by involving people who are considered to be "opinion leaders" in healthcare. An analysis of 12 studies shows opinion leaders have a definite impact on how much research evidence healthcare professionals use in clinical practice.

Identifying leaders

But who are these opinion leaders? They are the men and women who are seen by healthcare professionals to be likeable, trustworthy and influential. And it is because of this influence that they can educate and persuade healthcare providers to use evidence when treating and managing patients.

There are many ways to determine who might be considered one of these likable, trustworthy and influential people. According to the studies reviewed by Doumit, Gattellari, Grimshaw and O'Brien, there are four ways to identify opinion leaders in a hospital or clinic. The "observation method" uses an independent observer to identify opinion leaders within a group of professionals as they interact at work. The "self-designating method" asks members of a professional network whether they consider themselves to be an opinion leader. The "informant method" asks individuals to name the people they feel are the most influential. Finally, the "sociometric method" asks members of a network to judge individuals according to the extent to which they have educational influence and whether they are knowledgeable and devoted to others' welfare.

It is important to note that identifying opinion leaders can take a lot of work and can be hard to validate. This makes it more difficult to use opinion leaders widely as a way to spread ideas about research use in everyday practice.

Spreading influence

When it comes to measuring effectiveness, it is not clear which is more persuasive - formal lectures in a lecture hall, or less formal discussions outside of it. Either way, it is important which person is chosen to deliver the message; research shows that when it comes to encouraging change, opinion leaders' views have greater sway than others' constructive criticism.

Once opinion leaders are identified, there are many ways they can help healthcare professionals boost the amount of research being used in daily practice. For example, opinion leaders can discuss the use of research in one-to-one or small-group teaching sessions. They can also do this in large teaching sessions, while visiting individual healthcare providers' offices, or as part of their role in mentorships or preceptorships.

Opinion leaders' views appear to be as effective as distributing educational materials, auditing performance and providing feedback, and collaboration between different care providers in educating healthcare practitioners with efforts such as a public health campaign. However, the use of reminders by practitioners seems to have greater impact than any of these.

Reference

Doumit G et al. 2007. "Local opinion leaders: Effects on professional practice and health care outcomes." Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD000125. DOI: 10.1002/14651858.CD000125.pub3.

This summary is an interpretation and is not necessarily endorsed by the author(s) of the work cited.