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

Doumit G, Gattellari M, Grimshaw J, O'Brien MA

Summary

This summary of a Cochrane review presents what we know from research about the effect of opinion leaders to promote evidence based practice. The review shows that

• Opinion leaders promote evidence based practice. These results are based on moderate quality evidence.
• It is not clear whether the effect will occur in clinics and other settings, since most of the studies were in hospitals. It is not known if opinion leaders have certain professional or personality traits that affect whether they are successful or not. More also needs to be known specifically about what opinion leaders do and how they do it.

Who are opinion leaders and how could they promote evidence based practice?
Opinion leaders are people who are seen as likeable, trustworthy and influential. Because of their influence, it is thought that opinion leaders may be able to help and persuade health care providers to use evidence when treating and managing patients.

There are many ways to identify who are the opinion leaders in a hospital or clinic. There are also many ways opinion leaders can help or persuade people to change. For example, opinion leaders could provide one-to-one or small group teaching, visits to a visit the whole community or go to the health care providers' offices. Opinion leaders could also provide informal education or formal education as lectures. It is not clear what are the best ways to do it.

What are the results of this review?
Some studies tested whether opinion leaders alone could promote evidence based practice. Other studies tested opinion leaders along with other ways, such as reminders, audit and feedback, distributing education materials or seminars. Most tried to change the behaviours of doctors. Most studies were in the United States and also in hospitals. Studies lasted about 2 to 15 months.

Benefits of opinion leaders
Opinion leaders promote evidence based practice. This result is based on moderate quality evidence.

Opinion leaders identified by asking people "who are the opinion leaders?" on a questionnaire are more likely to change behaviour than opinion leaders that are identified by asking people to judge others who were pre-selected as opinion leaders.