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Pharmacist-led academic detailing intervention in primary care: a mixed methods feasibility study

  • David O. RiordanEmail author
  • Eimir Hurley
  • Carol Sinnott
  • Rose Galvin
  • Kieran Dalton
  • Patricia M. Kearney
  • James D. Halpin
  • Stephen Byrne
Research Article

Abstract

Background Academic detailing is a form of continuing medical education in which a trained health professional such as a physician or pharmacist visits prescribers in their practice to provide evidence-based information. While academic detailing has been adopted in other countries, this strategy is not routinely used in Ireland. Objective The aim of this study was to assess the feasibility and acceptability to General Practitioners (GPs) of a pharmacist-led academic detailing intervention in Ireland. Setting General Practice in County Cork, Ireland. Method A mixed methods feasibility study comprising a pharmacist-led academic detailing intervention on urinary incontinence in older people, quantitative data from patient medical records, and qualitative data from focus groups with GPs. The medical records for all patients aged ≥ 65 years who were attending a participating GP with a diagnosis of urinary incontinence were analysed using a before-after approach. The measures of prescribing assessed before and after the intervention were: LUTS-FORTA criteria, Drug Burden Index, and the Anticholinergic Cognitive Burden scale. Focus groups were carried out with GPs who participated in the academic detailing intervention. Main outcome measure The quantitative prescribing patterns of the GPs and their qualitative responses from the focus groups. Results Twenty-three GPs participated in the academic detailing intervention from a selection of different types of general practice. The medical records of 154 patients were analysed. There was minimal or no change in any of the prescribing measures used. Fourteen GPs attended focus groups. GPs considered the topic of urinary incontinence as relevant to general practice. Participants appreciated the succinct nature of the information in the educational materials but expressed a preference for a more easily retrievable format, such as an online version rather than paper-based. Conclusion This study demonstrated that a pharmacist-led academic detailing intervention was acceptable to GPs in Ireland. Further research is needed in a larger population evaluating the impact and cost effectiveness of academic detailing to optimise patient care.

Keywords

Drug prescriptions Evidence-based education Interprofessional relations Ireland Practice patterns Primary care Quality improvement 

Notes

Acknowledgements

The authors would like to acknowledge all the GPs who agreed to participate in this study. Additionally, gratitude is expressed to Alosa Health, who developed the academic detailing intervention “Evaluating and managing urinary incontinence”, and granted the authors permission to use their educational materials for this study. Alosa Health is a US non-profit which specialises in academic detailing. This body evaluates the evidence on clinical topics and synthesises the information into a ‘user-friendly’ format to be used in the interaction between the academic detailer and the clinicians. They provide information to improve clinical decision making and have no affiliation with any pharmaceutical company.

Funding

This research was funded by the Health Research Board SPHeRE/2013/1.

Conflicts of interest

There are no conflicts of interest to declare.

Supplementary material

11096_2019_787_MOESM1_ESM.docx (37 kb)
Supplementary material 1 (DOCX 37 kb)

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Pharmaceutical Care Research Group, Cavanagh Pharmacy Building, School of Pharmacy, University College CorkCorkRepublic of Ireland
  2. 2.Centre for Health Policy and Management, Trinity College DublinDublinRepublic of Ireland
  3. 3.The Healthcare Improvement Studies (THIS) Institute, University of CambridgeCambridgeUK
  4. 4.Department of Clinical TherapiesHealth Research Institute, University of LimerickLimerickRepublic of Ireland
  5. 5.School of Public Health, University College CorkCorkRepublic of Ireland
  6. 6.Department of Elderly MedicineUniversity Hospital LimerickLimerickRepublic of Ireland

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