Advances in Medical Education and Practice (Aug 2019)
Academic detailing as a method of continuing medical education
Abstract
Roar Dyrkorn,1 Harald Christian Langaas,2 Trude Giverhaug,3 Ketil Arne Espnes,1 Debra Rowett,4 Olav Spigset1,51Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway; 2Regional Medicines Information and Pharmacovigilance Centre (RELIS), Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway; 3Regional Medicines Information and Pharmacovigilance Centre (RELIS), University Hospital of North-norway, Tromsoe, North-Norway; 4Repatriation General Hospital, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia; 5Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, NorwayCorrespondence: Roar DyrkornDepartment of Clinical Pharmacology, St. Olav University Hospital, 7006 Trondheim, NorwayEmail [email protected]: 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
