Background There is increasing evidence that clinical guidelines can lead to improvements in both the process and outcome of care[1]. They figure prominently within the UK, particularly since the inception of the Scottish Intercollegiate Guidelines Network (SIGN) and the National Institute for Health and Clinical Excellence (NICE). However, clinical guidelines are not self-implementing and there is a growing body of research that demonstrates the effectiveness of various implementation strategies[1]. This has suggested that while the commonly used strategy of the postal distribution of educational materials alone may change clinician’s behaviour it is unlikely to lead to large changes in practice. Educational outreach visits, using a trained person to meet face-to-face with a health care professional to provide information, may improve practice, especially prescribing behaviour[1,2]. Previous studies of the effectiveness of outreach visiting in the UK NHS have used local pharmacists as the visitors[3,4]. All Primary Care Trusts (PCTs) in England employ Pharmaceutical Advisers who are pharmacists whose role is to provide, from a wide clinical and health service management perspective, advice on prescribing and related areas to general practitioners (GPs). Pharmaceutical Advisers routinely visit general practices and are seen as change agents; however, the formal delivery of educational outreach by them has not been evaluated.