Academic detailing as a method of continuing medical education

Figures & data

Table 1 Advantages and disadvantages with academic detailing versus group meetings as methods for changing drug prescribing practices among general practitioners (GPs)

Method	Advantages	Disadvantages
Academic detailing^a	Time-effective for the GP^b Messages can be tailored to the GP’s current understanding and behaviour One-to-one interaction keeps focus More effective than other methods for changing prescribing	Time-consuming for the academic detailer Higher costs than group visits Not possible for the GP to discuss with colleagues during the meeting
Group meetings	Time-effective for the academic detailer (approximately 45 mins for a group meeting to see all GPs in a practice) Lower costs than one-to-one visits In a good group setting sharing and discussion with colleagues is possible	More time-consuming for the GP than a 20 mins one-to-one meeting Difficult to tailor the messages to the individual GPs Easier for the GP to be unfocused than during a one-to-one visit The group setting can be a barrier for the individual GP to ask questions

Notes: ^aThe term “academic detailing” is here specifically used to describe a one-to-one visit. ^bIn Norway, the scheduled time for a one-to-one visit is 20 mins.

Figure 1 The complexity of practice change and the underlying theoretical frameworks. Academic detailing is placed under “Skill development” but it also has a place under “Motivation” and under “Reinforcement” when the general practitioner is revisited. Data f rom Elseviers M et al drug utilization research: methods and applications, Wiley-Blackwell, 2016, page 474. With permission from Wiley-Blackwell.¹⁶

Figure 2 The life cycle of the academic detailing program in Norway.

Table 2 Norwegian general practitioners’ evaluation of the academic detailing campaign (n=213)

Question	Percent “yes”, NSAIDs campaign
Were 20 mins a suitable time frame for the topic?	92%
Did you get useful information about the topic?	98%
Was the topic relevant for your practice?	99%
Is academic detailing a suitable method for producer-independent, evidence-based information?	90%
Would you probably or most probably welcome a new visit on another topic?	98%

Abbreviation: NSAIDs, non-steroidal anti-inflammatory drugs.

Figure 3 Actual and modelled prescription of diclofenac 12 months before and after the academic detailing campaign (vertical dashed line) targeting general practitioners in the cities of Trondheim (A) and Tromsoe (B), compared with the rest of Norway. Reproduced under the terms of the creative commons attribution 4.0 international licence (http://creativecommons.org/licenses/by/4.0/); Langaas HC, Hurley E, Dyrkorn R, Spigset O. Effectiveness of an academic detailing intervention in primary care on the prescribing of non-steroidal anti-inflammatory drugs. Eur J Clin Pharmacol. 2019;75(4):577–86.²⁵

Figure 4 Actual and modelled prescription of naproxen 12 months before and after the academic detailing campaign (vertical dashed line) targeting general practitioners in the cities of Trondheim (A) and Tromsoe (B), compared with the rest of Norway. (Reproduced under the terms of the creative commons attribution 4.0 international licence (http://creativecommons.org/licenses/by/4.0/)). Langaas HC, Hurley E, Dyrkorn R, Spigset O. Effectiveness of an academic detailing intervention in primary care on the prescribing of non-steroidal anti-inflammatory drugs. Eur J Clin Pharmacol. 2019;75(4):577–86.²⁵

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

● Focusing programs on specific categories of physicians as well as on their opinion leader.

● Investigating baseline knowledge and motivations for current activity.

● Defining clear educational and behavioral objectives.

● Establishing credibility through a respected organizational identity, referencing authoritative and unbiased sources of information, and presenting both sides of controversial issues.

● Stimulating active participation by physicians in educational interactions.

● Using concise graphic educational materials that highlight and repeat essential messages.

● Providing positive reinforcement of improved practices at follow-up visits.

Elseviers M, Wettermark B, Almarsdottir AB et al, editors. Drug Utilization Research: Methods and Applications. West Sussex: Wiley-Blackwell, 2016; p 474.

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