Evaluation of Academic Detailing Within a Coordinated Care Trial

Abstract

Background: Academic detailing has been identified as an intervention that modifies health professionals' practice, particularly prescribing.Aim: To assess the impact of academic detailing on general practitioners' (GPs) prescribing for heart failure, and chronic pain associated with osteoarthritis, in an elderly population.Method: This was a quasi‐experimental study embedded within a coordinated care trial, with a 12‐month follow‐up. 1151120 (96%) of GPs invited to participate received academic detailing visits by experienced teaching‐hospital clinical pharmacists between July 1998 and July 1999. The pharmacological management of two conditions was addressed: heart failure in Phase 1, and chronic pain associated with osteoarthritis in Phase 2. Data from the Pharmaceutical Benefits Scheme (PBS) were analysed for changes in prescribing. The perceptions of the GP and pharmacist were also assessed.Results: Consistent with key messages, non‐steroidal anti‐inflammatory drug (NSAID) use decreased in Phase I, and in Phase 2long‐acting NSAID use decreased and low‐dose tricyclic antidepressant use increased. Inconsistent with key messages of Phase 1, angiotensin converting enzyme inhibitor prescribing for heart failure did not change. GPs and pharmacists were highly satisfied with the project.Conclusion: Academic detailing visits to GPs were partly successful in changing prescribing practices for heart failure, and pain management of osteoarthritis. Initiatives such as this may strengthen professional links between pharmacists and GPs and benefit patients through enhanced quality use of medicines.