Using Clinical Evidence in a National Continuing Medical Education Program in Italy

May 2007 | Volume 4 | Issue 5 | e113 Interest in evidence-based medicine (EBM) is growing in Italy, although its impact upon health policies and clinical practice is unclear. Rather than getting health information from unbiased evidence-based sources, doctors in Italy still rely heavily upon the pharmaceutical industry for their information needs. For example, a recent survey showed that general practitioners receive 11 visits per week by pharmaceutical sales representatives [1]. The study suggested that this information is considered complete and suffi ciently reliable by many doctors. In an effort to ensure that all physicians have access to valid and reliable evidence on drug effectiveness and safety, the Italian Drug Agency (AIFA) launched a program to disseminate independent and unbiased information. The agency did this by translating Clinical Evidence, a compendium of the best available evidence on treating a wide range of common conditions (Box 1), into Italian and distributing it freely. By 2006, the fourth Italian edition (based on Clinical Evidence volume 14) had been published. The online Italian version of Clinical Evidence is freely available to all 248,000 doctors in practice in Italy. In 1999, the fi rst free distribution of 50,000 copies of Clinical Evidence was assessed through a survey exploring doctors’ judgement of its validity, relevance, and usability. Results showed that the compendium had been well received, and confi rmed doctors’ preference for problemdriven information and the key role of a strong endorsement from health authorities for its implementation [2]. A compulsory system of continuing medical education (CME) for all health professionals was introduced in Italy in 1998, based on credits awarded for time spent on educational activities. The more traditional form of acquiring CME is to attend lectures and conferences; it is much more rare for doctors to be exposed to small group interactive events. In order to maximise the effectiveness of the fi nancial commitment for disseminating Clinical Evidence, and to speed up the diffusion of EBM, AIFA sponsored a free-access e-learning system, based on Clinical Evidence, called ECCE (the Italian acronym for Continuing Education Clinical Evidence).