Academic detailing as a method of continuing medical education

Abstract

Introduction

Academic detailing is an interactive educational outreach to prescribers to present unbiased, non-commercial, evidence-based information, mostly about medications, with the goal of improving patient care. Academic detailing in Norway is an approach for providing continuing medical education to general practitioners (GPs). The basis of academic detailing is a one-to-one discussion between a trained health professional (the academic detailer) and the GP at the GP’s workplace.

Method

Our first campaign was named “Better use of non-steroidal anti-inflammatory drugs (NSAIDs)”, which aim was to reduce the use of diclofenac due to the risk of serious cardiovascular adverse events. At the same time we advised the GPs to use naproxen as the drug of choice if an NSAID was needed. We did a one-to-one intervention in two cities, where a trained academic detailer met the GP during office hours. A total of 247 GPs were invited to participate and 213 visits (86%) were completed. This article reviews the theoretical framework underlying the method and describes the development and implementation of academic detailing to GPs in Norway.

Results

More than 90% the participating GPs considered academic detailing a suitable method for providing up-to-date evidence-based, manufacturer-independent information, and nearly all would most likely or probably welcome another visit. After the intervention there was a reduction of diclofenac prescribing of 16% and 18%, respectively, in the two cities.

Conclusion

We consider that academic detailing is a suitable method to bring the best available evidence to the point at which care is delivered, to achieve the best for the patients. According to the Norwegian GPs’ evaluation, it is a key supplement to other methods of continuing medical education. To have maximum impact, it is important that academic detailing is practiced according to the consensus that has evolved in the USA and Australia.

Keywords:

• academic detailing
• educational outreach visits
• general practitioners
• general practice
• quality improvement

Ethical requirement

As this evaluation did not involve any patients, approval from an Ethical Committee was not needed according to Norwegian legislation. Participating GPs enrolled themselves after an invitation letter and analysis were done with depersonalized data.

Aknowlegdements

We thank all participating academic detailers for their dedication and enthusiasm. The study received funding from the Norwegian Ministry of Health

Author contributions

All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

Mr Harald Christian Langaas reports grants from Norwegian Directorate of Health, during the conduct of the study. The authors report no other conflicts of interest in this work.

Box 1 The steps of academic detailing^1,2,13