A pilot study evaluating alternative approaches of academic detailing in rural family practice clinics

Abstract

BackgroundAcademic detailing is an interactive, convenient, and user-friendly approach to delivering non-commercial education to healthcare clinicians. While evidence suggests academic detailing is associated with improvements in prescribing behavior, uncertainty exists about generalizability and scalability in diverse settings. Our study evaluates different models of delivering academic detailing in a rural family medicine setting.MethodsWe conducted a pilot project to assess the feasibility, effectiveness, and satisfaction with academic detailing delivered face-to-face as compared to a modified approach using distance-learning technology. The recipients were four family medicine clinics within the Oregon Rural Practice-based Research Network (ORPRN). Two clinics were allocated to receive face-to-face detailing and two received outreach through video conferencing or asynchronous web-based outreach. Surveys at midpoint and completion were used to assess effectiveness and satisfaction.ResultsEach clinic received four outreach visits over an eight month period. Topics included treatment-resistant depression, management of atypical antipsychotics, drugs for insomnia, and benzodiazepine tapering. Overall, 90% of participating clinicians were satisfied with the program. Respondents who received in person detailing reported a higher likelihood of changing their behavior compared to respondents in the distance detailing group for five of seven content areas. While 90%-100% of respondents indicated they would continue to participate if the program were continued, the likelihood of participation declined if only distance approaches were offered.ConclusionsWe found strong support and satisfaction for the program among participating clinicians. Participants favored in-person approaches to distance interactions. Future efforts will be directed at quantitative methods for evaluating the economic and clinical effectiveness of detailing in rural family practice settings.

Expanding Cessation Pharmacotherapy Via Videoconference Educational Outreach to Prescribers

“…38 To our knowledge, this is the first randomized trial comparing videoconference to in-person educational outreach with audit and feedback aimed at improving prescribing practices in a state mental health system serving people with severe mental illnesses. Similar to at least one previous feasibility report, 34 clinicians were satisfied with the technology-delivered educational intervention. In this study, prescribing outcomes were not consistently different among patients whose clinicians who received the intervention in-person compared to those whose clinicians received it via videoconference.…”

“…However, little research has evaluated whether educational outreach can be effectively provided via videoconference. 34 As educational outreach relies on the interaction between the educator and the practicing physician, it is not known whether educational outreach via videoconference can result in changes in prescribing. To address this knowledge gap, we conducted a randomized trial comparing videoconference to in-person educational outreach with audit and feedback for smoking cessation pharmacotherapy within a state community mental health system.…”

Virtual Educational Outreach Intervention in Primary Care Based on the Principles of Academic Detailing

“…We have found only one example of this type of outreach program in the literature. Hartung et al 23 developed a distance-learning AD model for use with rural primary care practices in Oregon and compared it with more traditional in-person AD. Two practices received the video conference–based and two in-person detailing strategies in four visits over 8 months.…”

Implementing an Injury Prevention Briefing to aid delivery of key fire safety messages in UK children’s centres: qualitative study nested within a multi-centre randomised controlled trial

“…This model combining the art and science of injury prevention has potential to enhance implementation of public health interventions and to support frontline staff charged with their delivery; it could be used in a range of settings and other public health areas. Similarities between this approach and developments in ‘public health detailing’ or ‘academic detailing’ could be explored [ 24 ].…”