Tele-education as a strategy to improve the implementation of perioperative recommendations of a clinical practice guideline for amputees: A randomized controlled trial

Abstract Objective To evaluate the effectiveness of a Tele-education strategy for improving the implementation of the perioperative recommendations of a clinical practice guideline (CPG) for lower limb amputee patients in health institutions. Design: Cluster randomized community intervention study. Participants: Three classes of participants took part in the study: Health institutions in which amputation or reconstruction surgeries were performed, and the health professionals and patients of these institutions. Methods There were two interventions, a strong strategy consisting of a tele-education online course based on the CPG for people with amputations (intervention group) and a weak strategy consisting of passive dissemination of the CPG (control group). The primary outcome was compliance with the prioritized perioperative recommendations of the CPG. Results Information was obtained from clinical charts of 418 amputated patients from six health institutions. Only 30% of the invited health professionals completed the online course. There were no significant differences in the compliance with perioperative recommendations between groups, with compliance scores of 42.7% in the intervention group and 43.1% in the control group. Conclusion After devising a Tele-educational strategy focused on significant patient results, we found low compliance with the evidence-based recommendations, and the desired behavioral changes in professionals were not achieved.