Intended for healthcare professionals

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Rapid response to:


Understanding the consequences of education inequality on cardiovascular disease: mendelian randomisation study

BMJ 2019; 365 doi: (Published 22 May 2019) Cite this as: BMJ 2019;365:l1855

Rapid Response:

Employee or patient health education is ineffective

"Mass media health campaigns may not be able to directly change behaviour in most instances, based on available evidence, but they can affect knowledge and awareness." A systematic review and other reviews of the evidence.

An extensive systematic review of systematic reviews and meta-analyses of randomized controlled trials (RCTs) found no increased effectiveness for theory-based compared to non-theory-based interventions for effectiveness of outcomes relating to health behaviour.

Even after money incentives paid to patients on chronic pharmaceutical therapies, their compliance is not improved.

A recent randomized trial involving 32,974 employees who participated in 18 months of multicomponent workplace wellness programs comprising 8 modules focused on nutrition, physical activity, stress reduction, and related topics, proved that such interventions did not result in significant differences in clinical measures of health, health care spending and utilization, and employment outcomes.
There were no significant effects on 27 self-reported health outcomes and behaviors (including self-reported health, sleep quality, and food choices), 10 clinical markers of health (including cholesterol, blood pressure, and body mass index), 38 medical and pharmaceutical spending and utilization measures, and 3 employment outcomes (absenteeism, job tenure, and job performance).

Large meta-analysis of previously published relative studies proved that even intense financial education to improve financial literacy fades away after a few months and only influences 0.1% of citizens' consumer behavior.
I seriously doubt structured and persistently reinforced patient education could work any better.

Competing interests: No competing interests

23 May 2019
Stavros Saripanidis
Consultant in Obstetrics and Gynaecology
Thessaloniki, Greece