A Multifaceted Continuing Medical Education Intervention to Improve Primary Care Physicians Performance In Mexico Hortensia Reyes, Ricardo Perez-Cuevas, Sergio Flores, Patricia Tome, Juan A Trejo, Onofre Muoz Mexican Institute of Social Security Background Inappropriate case management for common diseases in primary care level is a relevant problem in many countries. Most of continuing medical education activities for primary care physicians in Mexico do not have impact in improving quality of care Physicians practices are not always in accordance with updated clinical evidence. Objective To evaluate the impact of a multi- faceted educational intervention on primary care physicians, to improve case-management of acute respiratory infections, hypertension and type 2 diabetes Methods Design: Nonrandomised prospective controlled Trial Setting: Eight primary care facilities belonging to Mexican Institute of Social Security, in four different regions of Mexico Study population: Family physicians Methods Components 1.Formulation of evidence-based clinical guidelines 2.Training of selected clinical tutors from referral hospital 3.Educational intervention Educational intervention activities The multifaceted strategy comprises three stages to be completed in a seven-month period: Interactive workshops In-service training through individual tutorial Round-table Peer review sessions Outcome measures Appropriateness of physicians case- management according to the clinical guideline: ARI:- Prescription of antibiotics - Patients education, including mothers education whether the patient was a child, regarding the alarm signs HT: - Prescription of antihypertensive drugs DM: - Prescription of hypoglycemic drugs or insulin In both chronic illnesses dietary and exercise recommendations Evaluation Acute respiratory infections: baseline evaluation follow-up evaluations after every intervention stage Hypertension and Type 2 diabetes: baseline evaluation Follow-up at six and twelve months Evaluations consisted of: Interviewing patients Reviewing clinical records Reviewing prescriptions