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Evidence for and Implementation of Academic Detailing

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Improving Use of Medicines and Medical Tests in Primary Care

Abstract

Academic detailing is a widely practiced and proven intervention for supporting behavior change by health professionals and enhancing health care. It draws on principles of social marketing, adult learning, social cognitive theory, the trans-theoretical model of change and diffusion of innovation. Studies and meta-analyses have consistently reported effectiveness for academic detailing in prescribing programs. It has also been used successfully in a range of other contexts, including for diagnostic tests, immunization and public health programs. The components of an academic detailing program extend far beyond the visible detailing encounter itself. These include: collating and synthesizing the evidence to support a change in practice; understanding the motivation for the current practice and barriers to change; designing the program to not only support the change but to meet additional needs of participants; designing attractive and useful resources to support the visit; and developing clear objectives and key messages. Academic detailing is a cost-effective intervention in many situations, understanding when, how, why and in what contexts will be important for future evaluation of academic detailing services.

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References

  • Agency for Healthcare Research and Quality. (2013). Module 10. Academic detailing as a quality improvement tool. Retrieved from http://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/pfhandbook/mod10.htm.

  • Andreasen, A. R. (1995). Marketing social change: Changing behavior to promote health, social development and the environment. San Francisco: Jossey-Bass.

    Google Scholar 

  • Ard, K. L., Edelstein, Z. R., Bolduc, P., Daskalakis, D., Gandhi, A. D., Krakower, D. S., … Keuroghlian, A. S. (2019). Public health detailing for human immunodeficiency virus pre-exposure prophylaxis. Clinical Infectious Diseases, 68(5), 860–864. https://doi.org/10.1093/cid/ciy573.

  • Avery, A. J., Rodgers, S., Cantrill, J. A., Armstrong, S., Cresswell, K., Eden, M., … Sheikh, A. (2012). A pharmacist-led information technology intervention for medication errors (PINCER): A multicentre, cluster randomised, controlled trial and cost-effectiveness analysis. The Lancet, 379(9823), 1310–1319. https://doi.org/10.1016/S0140-6736(11)61817-5.

  • Avorn, J. (2017). Academic detailing “marketing” the best evidence to clinicians. JAMA—Journal of the American Medical Association, 317(4), 361–362. https://doi.org/10.1001/jama.2016.16036.

    Article  Google Scholar 

  • Avorn, J. L., & Soumerai, S. B. (1983). Improving drug-therapy decisions through educational outreach. New England Journal of Medicine, 308(24). https://doi.org/10.1056/nejm198306163082406.

  • Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Broadhurst, N. A., Barton, C. A., Yelland, L. N., Martin, D. K., & Beilby, J. J. (2006). Managing shoulder pain in general practice: The value of academic detailing. Australian Family Physician, 35(9), 751–752.

    PubMed  Google Scholar 

  • Bruyndonckx, R., Verhoeven, V., Anthierens, S., Cornelis, K., Ackaert, K., Gielen, B., & Coenen, S. (2018). The implementation of academic detailing and its effectiveness on appropriate prescribing of pain relief medication: A real-world cluster randomized trial in Belgian general practices. Implementation Science, 13(1), 6. https://doi.org/10.1186/s13012-017-0703-8.

  • Caffrey, A. R., DeAngelis, J. M., Ward, K. E., Orr, K. K., Morrill, H. J., Gosciminski, M., & LaPlante, K. L. (2018). A pharmacist-driven academic detailing program to increase adult pneumococcal vaccination. Journal of the American Pharmacists Association (2003), 58(3), 303–310. https://doi.org/10.1016/j.japh.2017.08.010.

  • Collier, A., Rowett, D., Allcroft, P., Greene, A., & Currow, D. C. (2015). Academic detailing of general practitioners by a respiratory physician for diagnosis and management of refractory breathlessness: A randomised pilot study. BMC Health Services Research, 15, 193. https://doi.org/10.1186/s12913-015-0861-9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Croskerry, P., Singhal, G., & Mamede, S. (2013). Cognitive debiasing 1: Origins of bias and theory of debiasing. BMJ Quality & Safety, 22(Suppl. 2), ii58. https://doi.org/10.1136/bmjqs-2012-001712.

  • Dougherty, M. K., Brenner, A. T., Crockett, S. D., Gupta, S., Wheeler, S. B., Coker-Schwimmer, M., … Reuland, D. S. (2018). Evaluation of interventions intended to increase colorectal cancer screening rates in the United States: A systematic review and meta-analysis. JAMA Internal Medicine, 178(12), 1645–1658. https://doi.org/10.1001/jamainternmed.2018.4637.

  • Dyrkorn, R., Langaas, H. C., Giverhaug, T., Espnes, K. A, Rowett, D., & Spigset, O. (2019). Academic detailing as a method of continuing medical education. Advances in Medical Education and Practice, 10, 717–725. https://doi.org/doi:10.2147/AMEP.S206073.

  • Figueiras, J. A., Sastre, J. I., Tato, J. F., Rodríguez, J. C., Lado, J. E., Caamaño, J. F., & Gestal-Otero, J. J. (2001). One-to-one versus group sessions to improve prescription in primary care: A pragmatic randomized controlled trial. Medical Care, 39(2), 158–167. https://doi.org/10.1097/00005650-200102000-00006.

  • Fincham, J. E. (2016). Improving patient outcomes and drug prescribing cost-effectiveness through academic detailing. American Health and Drug Benefits, 9(1), 50.

    Google Scholar 

  • Freemantle, N., & Eastaugh, J. (2002a). Using effectiveness studies for prescribing research, part 1. Journal of Clinical Pharmacy and Therapeutics, 27(5), 383–389.

    Article  CAS  Google Scholar 

  • Freemantle, N., & Eastaugh, J. (2002b). Using effectiveness studies for prescribing research, part 2. Journal of Clinical Pharmacy and Therapeutics, 27(6), 469–473.

    Article  CAS  Google Scholar 

  • Gabbay, J., & le May, A. (2016). Mindlines: Making sense of evidence in practice. British Journal of General Practice, 66(649):402–403. https://doi.org/doi:10.3399/bjgp16X686221.

  • Greene, J. A., & Podolsky, S. H. (2009). Keeping modern in medicine: Pharmaceutical promotion and physician education in Postwar America (Author abstract) (Report). Bulletin of the History of Medicine, 83(2), 331. https://doi.org/10.1353/bhm.0.0218.

  • Grimshaw, J. M., Thomas, R. E., MacLennan, G., Fraser, C., Ramsay, C., & Vale, L. (2004). Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technology Assessment, 8, 1–72.

    Google Scholar 

  • Hermes, E., Sernyak, M., & Rosenheck, R. (2012). Impact of a program encouraging the use of generic antipsychotics. The American Journal of Managed Care, 18(8), E307–E314.

    PubMed  Google Scholar 

  • Ho, K., Nguyen, A., Jarvis-Selinger, S., Novak Lauscher, H., Cressman, C., & Zibrik, L. (2013). Technology-enabled academic detailing: Computer-mediated education between pharmacists and physicians for evidence-based prescribing. International Journal of Medical Informatics, 82(9), 762–771. https://doi.org/10.1016/j.ijmedinf.2013.04.011.

    Article  PubMed  Google Scholar 

  • Jin, M., Naumann, T., Regier, L., Bugden, S., Allen, M., Salach, L., … Dolovich, L. (2012). A brief overview of academic detailing in Canada: Another role for pharmacists. Canadian Pharmacists Journal/Revue des Pharmaciens du Canada, 145(3), 142–146.e142. https://doi.org/10.3821/145.3.cpj142.

  • Kingsland, M., Doherty, E., Anderson, A. E., Crooks, K., Tully, B., Tremain, D., … Wiggers, J. (2018). A practice change intervention to improve antenatal care addressing alcohol consumption by women during pregnancy: Research protocol for a randomised stepped-wedge cluster trial. Implementation Science, 13(1), 112. https://doi.org/10.1186/s13012-018-0806-x.

  • Kotler, P., & Murray, M. (1975). Third sector management—The role of marketing. Public Administration Review, 35(5), 467–472. https://doi.org/10.2307/974176.

    Article  Google Scholar 

  • Kotler, P., & Zaltman, G. (1971). Social marketing: An approach to planned social change. Journal of Marketing, 35(3), 3.

    Article  CAS  Google Scholar 

  • Langaas, H. C., Hurley, E., Dyrkorn, R., & Spigset, O. (2019). Effectiveness of an academic detailing intervention in primary care on the prescribing of non-steroidal anti-inflammatory drugs. European Journal of Clinical Pharmacology, 75(4), 577–586. https://doi.org/10.1007/s00228-018-02611-y.

    Article  CAS  PubMed  Google Scholar 

  • Ly, E., Peddecord, K. M., Wang, W., Ralston, K., & Sawyer, M. H. (2015). Student column: Using academic detailing to improve childhood influenza vaccination rates in San Diego. Public Health Reports, 130(2), 179–187. https://doi.org/10.1177/003335491513000213.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mader, E. M., Fox, C. H., Epling, J. W., Noronha, G. J., Swanger, C. M., Wisniewski, A. M., … Morley, C. P. (2016). A practice facilitation and academic detailing intervention can improve cancer screening rates in primary care safety net clinics. Journal of the American Board of Family Medicine, 29(5), 533–542. https://doi.org/10.3122/jabfm.2016.05.16010.

  • Mason, J., Freemantle, N., Nazareth, I., Eccles, M., Haines, A., & Drummond, M. (2001). When is it cost-effective to change the behavior of health professionals? Journal of the American Medical Association, 286(23), 2988–2992. https://doi.org/10.1001/jama.286.23.2988.

    Article  CAS  PubMed  Google Scholar 

  • May, F. W., Rowett, D. S., Gilbert, A. L., McNeece, J. I., & Hurley, E. (1999). Outcomes of an educational-outreach service for community medical practitioners: Non-steroidal anti-inflammatory drugs. Medical Journal of Australia, 170(10), 471–474.

    Article  CAS  Google Scholar 

  • McIntosh, K. A., Maxwell, D. J., Pulver, L. K., Horn, F., Robertson, M. B., Kaye, K. I., … Tett, S. E. (2011). A quality improvement initiative to improve adherence to national guidelines for empiric management of community-acquired pneumonia in emergency departments. International Journal for Quality in Health Care, 23(2), 142–150. https://doi.org/10.1093/intqhc/mzq077.

  • Midboe, A. M., Wu, J., Erhardt, T., Carmichael, J. M., Bounthavong, M., Christopher, M. L. D., & Gale, R. C. (2018). Academic detailing to improve opioid safety: Implementation lessons from a qualitative evaluation. Pain Medicine, 19(Suppl. 1), S46–S53. https://doi.org/10.1093/pm/pny085.

  • National Resource Centre for Academic Detailing. (2018). Example academic detailer/clinical educator job description. Retrieved from https://www.narcad.org/uploads/5/7/9/5/57955981/example_clinical_educator_job_description.pdf.

  • National Resource Centre for Academic Detailing. (2019). Why interactivity matters. Retrieved from https://www.narcad.org/blog/category/interactivity.

  • Naughton, C., Feely, J., & Bennett, K. (2009). A RCT evaluating the effectiveness and cost-effectiveness of academic detailing versus postal prescribing feedback in changing GP antibiotic prescribing. Journal of Evaluation in Clinical Practice, 15(5), 807–812. https://doi.org/10.1111/j.1365-2753.2008.01099.x.

    Article  PubMed  Google Scholar 

  • NPS MedicineWise. (2019). 2018 annual evaluation report. Sydney: NPS MedicineWise.

    Google Scholar 

  • O’Brien, M., Rogers, S., Jamtvedt, G., Oxman, D., Odgaard-Jensen, J., Kristoffersen, D. T., … Harvey, E. L. (2007). Educational outreach visits: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews (4), CD000409.

    Google Scholar 

  • Ostini, R., Hegney, D., Jackson, C., Williamson, M., Mackson, J. M., Gurman, K., … Tett, S. E. (2009). Systematic review of interventions to improve prescribing. Annals of Pharmacotherapy, 43(3), 502–513. https://doi.org/10.1345/aph.1L488.

  • Ostini, R., Tett, D., Hegney, J. M., Mackson, M., & Williamson, S. E. (2008). Why is the use of clopidogrel increasing rapidly in Australia? An exploration of geographical location, age, sex and cardiac stenting rates as possible influences on clopidogrel use. Pharmacoepidemiology and Drug Safety, 17(11), 1077–1090. https://doi.org/10.1002/pds.1638.

    Article  CAS  PubMed  Google Scholar 

  • Peterson, G. M., Thompson, A., Pulver, L. K., Robertson, M. B., Brieger, D., Wai, A., … Dmacs Project Group. (2012). Management of acute coronary syndromes at hospital discharge: Do targeted educational interventions improve practice quality? Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality, 34(1), 26–34. https://doi.org/10.1111/j.1945-1474.2011.00137.x.

  • Pond, C. D., Mant, A., Kehoe, L., Hewitt, H., & Brodaty, H. (1994). General practitioner diagnosis of depression and dementia in the elderly: Can academic detailing make a difference? Family Practice, 11(2), 141–147. https://doi.org/10.1093/fampra/11.2.141.

    Article  CAS  PubMed  Google Scholar 

  • Rogers, E. (1983). Diffusion of innovations. New York: Free Press.

    Google Scholar 

  • Ryan, C., Ross, S., Davey, P., Duncan, E. M., Fielding, S., Francis, J. J., … Bond, C. (2013). Junior doctors’ perceptions of their self-efficacy in prescribing, their prescribing errors and the possible causes of errors. British Journal of Clinical Pharmacology, 76(6), 980–987. https://doi.org/10.1111/bcp.12154.

  • Schaffner, W., Ray, W. A., Federspiel, C. F., & Miller, W. O. (1983). Improving antibiotic prescribing in office practice: A controlled trial of three educational methods. Journal of the American Medical Association, 250(13), 1728–1732. https://doi.org/10.1001/jama.1983.03340130046031.

    Article  CAS  PubMed  Google Scholar 

  • Segreti, J., House, H. R., & Siegel, R. E. (2005). Principles of antibiotic treatment of community-acquired pneumonia in the outpatient setting. The American Journal of Medicine, 118(7), 21–28. https://doi.org/10.1016/j.amjmed.2005.05.010.

    Article  Google Scholar 

  • Silagy, C., & May, F. (1997). A systematic review of current practices of academic detailing and opinion leader education in Australia and internationally.

    Google Scholar 

  • Simon, S. R., Majumdar, S. R., Prosser, L. A., Salem-Schatz, S., Warner, C., Kleinman, K., … Soumerai, S. B. (2005). Group versus individual academic detailing to improve the use of antihypertensive medications in primary care: A cluster-randomized controlled trial. The American Journal of Medicine, 118(5), 521–528. https://doi.org/10.1016/j.amjmed.2004.12.023.

  • Simon, S. R., Smith, D. H., Feldstein, A. C., Perrin, N., Yang, X., Zhou, Y., … Soumerai, S. B. (2006). Computerized prescribing alerts and group academic detailing to reduce the use of potentially inappropriate medications in older people. Journal of the American Geriatrics Society, 54(6), 963–968. https://doi.org/10.1111/j.1532-5415.2006.00734.x.

  • Soumerai, B. S., & Avorn, B. J. (1986). Economic and policy analysis of university-based drug “detailing”. Medical Care, 24(4), 313–331. https://doi.org/10.1097/00005650-198604000-00003.

    Article  CAS  PubMed  Google Scholar 

  • Soumerai, S. B., & Avorn, J. L. (1990). Principles of educational outreach (‘academic detailing’) to improve clinical decision making. Journal of the American Medical Association, 263(4). https://doi.org/10.1001/jama.1990.03440040088034.

  • Stevens, J., Trimboli, A., Samios, P., Steele, N., Welch, S., Thompson, P., … Kerr, S. (2019). A sustainable method to reduce postoperative oxycodone discharge prescribing in a metropolitan tertiary referral hospital. Anaesthesia, 74(3), 292–299. https://doi.org/10.1111/anae.14570.

  • Stone, C. A., May, F. W., Pinnock, C. B., Elwood, M., & Rowett, D. S. (2005). Prostate cancer, the PSA test and academic detailing in Australian general practice: An economic evaluation. Australian and New Zealand Journal of Public Health, 29(4), 349–357. https://doi.org/10.1111/j.1467-842X.2005.tb00206.x.

    Article  PubMed  Google Scholar 

  • US Department of Veterans’ Affairs. (2019). Pharmacy Benefit Management Services; Academic Detailing Service. Retrieved from https://www.pbm.va.gov/PBM/academicdetailingservice/AboutUs.asp.

  • van Eijk, M. E., Avorn, J., Porsius, A. J., & de Boer, A. (2001). Reducing prescribing of highly anticholinergic antidepressants for elderly people: Randomised trial of group versus individual academic detailing. BMJ, 322(7287), 654–657. https://doi.org/10.1136/bmj.322.7287.654.

    Article  PubMed  PubMed Central  Google Scholar 

  • Van Hoof, T. J., Harrison, L. G., Miller, N. E., Pappas, M. S., & Fischer, M. A. (2015). Characteristics of academic detailing: Results of a literature review. American Health & Drug Benefits, 8(8), 414–422.

    Google Scholar 

  • Van Hoof, T. J., Miller, N. E., & Meehan, T. P. (2013). Do published studies of educational outreach provide documentation of potentially important characteristics? American Journal of Medical Quality, 28(6), 480–484. https://doi.org/10.1177/1062860613476335.

    Article  PubMed  Google Scholar 

  • Weekes, L. M., Blogg, S., Jackson, S., & Hosking, K. (2018). NPS MedicineWise: 20 years of change. Journal of Pharmaceutical Policy and Practice, 11(1), 19. https://doi.org/10.1186/s40545-018-0145-y.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yeh, J. S., Franklin, J. M., Avorn, J., Landon, J., & Kesselheim, A. S. (2016). Association of industry payments to physicians with the prescribing of brand-name statins in Massachusetts (Report). JAMA Internal Medicine, 176(6), 763. https://doi.org/10.1001/jamainternmed.2016.1709.

  • Yeh, J. S., Van Hoof, T. J., & Fischer, M. A. (2016). Key features of academic detailing: Development of an expert consensus using the Delphi method. American Health & Drug Benefits, 9(1), 42–50.

    Google Scholar 

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Rowett, D. (2020). Evidence for and Implementation of Academic Detailing. In: Weekes, L. (eds) Improving Use of Medicines and Medical Tests in Primary Care. Springer, Singapore. https://doi.org/10.1007/978-981-15-2333-5_4

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