Academic Detailing in Diabetes: Using Outreach Education to Improve the Quality of Care

Overview

Journal Curr Diab Rep

Publisher Current Science

Specialty Endocrinology

Date 2016 Sep 3

PMID 27586191

Citations 10

Authors

Michael A Fischer

Affiliations

Soon will be listed here.

Abstract

Most diabetes care is provided in primary care settings, but typical primary care clinicians struggle to keep up with the latest evidence on diabetes screening, pharmacotherapy, and monitoring. Accordingly, many patients with diabetes are not receiving optimal guideline-based therapy. Relying on front-line clinicians on their own to assess the huge volume of new literature and incorporate it into their practice is unrealistic, and conventional continuing medical education has not proven adequate to address gaps in care. Academic detailing, direct educational outreach to clinicians that uses social marketing techniques to provide specific evidence-based recommendations, has been proven in clinical trials to improve the quality of care for a range of conditions. By directly engaging with clinicians to assess their needs, identify areas for change in practice, and provide them with specific tools to implement these changes, academic detailing can serve as a tool to improve care processes and outcomes for patients with diabetes.

Citing Articles

Expanding community pharmacists' scope of practice in relation to contraceptive counselling and referral: a protocol for a pragmatic, stepped-wedge, cluster randomised trial (ALLIANCE).

Mazza D, Assifi A, Hussainy S, Bateson D, Johnston S, Tomnay J BMJ Open. 2023; 13(8):e073154.

PMID: 37652588 PMC: 10476139. DOI: 10.1136/bmjopen-2023-073154.

Professional medical education approaches: mobilizing evidence for clinicians.

Lyu X, Li S Front Med (Lausanne). 2023; 10:1071545.

PMID: 37575990 PMC: 10419302. DOI: 10.3389/fmed.2023.1071545.

Improving rural and regional access to long-acting reversible contraception and medical abortion through nurse-led models of care, task-sharing and telehealth (ORIENT): a protocol for a stepped-wedge pragmatic cluster-randomised controlled trial in....

Mazza D, Shankar M, Botfield J, Moulton J, Chakraborty S, Black K BMJ Open. 2023; 13(3):e065137.

PMID: 36948556 PMC: 10040016. DOI: 10.1136/bmjopen-2022-065137.

Interventions to Increase Leukocyte Testing during Treatment with Dimethyl Fumarate.

Heidenreich P, Lin S, Gholami P, Moore V, Burk M, Glassman P Int J Environ Res Public Health. 2021; 18(19).

PMID: 34639610 PMC: 8507868. DOI: 10.3390/ijerph181910312.

Implementing work-related Mental health guidelines in general PRacticE (IMPRovE): a protocol for a hybrid III parallel cluster randomised controlled trial.

Mazza D, Chakraborty S, Camoes-Costa V, Kenardy J, Brijnath B, Mortimer D Implement Sci. 2021; 16(1):77.

PMID: 34348743 PMC: 8335858. DOI: 10.1186/s13012-021-01146-8.

References

New J, Mason J, Freemantle N, Teasdale S, Wong L, Bruce N . Educational outreach in diabetes to encourage practice nurses to use primary care hypertension and hyperlipidaemia guidelines (EDEN): a randomized controlled trial. Diabet Med. 2004; 21(6):599-603. DOI: 10.1111/j.1464-5491.2004.01213.x. View

Desai N, Shrank W, Fischer M, Avorn J, Liberman J, Schneeweiss S . Patterns of medication initiation in newly diagnosed diabetes mellitus: quality and cost implications. Am J Med. 2012; 125(3):302.e1-7. PMC: 4347833. DOI: 10.1016/j.amjmed.2011.07.033. View

Avorn J, Soumerai S . Improving drug-therapy decisions through educational outreach. A randomized controlled trial of academically based "detailing". N Engl J Med. 1983; 308(24):1457-63. DOI: 10.1056/NEJM198306163082406. View

Gorin S, Ashford A, Lantigua R, Desai M, Troxel A, Gemson D . Implementing academic detailing for breast cancer screening in underserved communities. Implement Sci. 2007; 2:43. PMC: 2266776. DOI: 10.1186/1748-5908-2-43. View

Soumerai S, Avorn J . Principles of educational outreach ('academic detailing') to improve clinical decision making. JAMA. 1990; 263(4):549-56. View

Davis D, OBrien M, Freemantle N, Wolf F, Mazmanian P, Taylor-Vaisey A . Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes?. JAMA. 1999; 282(9):867-74. DOI: 10.1001/jama.282.9.867. View

Fletcher S . Chairman's summary of the conference. Continuing education in the health professions: improving healthcare through lifelong learning. J Contin Educ Nurs. 2008; 39(3):112-8. DOI: 10.3928/00220124-20080301-09. View

Gorin S, Ashford A, Lantigua R, Hossain A, Desai M, Troxel A . Effectiveness of academic detailing on breast cancer screening among primary care physicians in an underserved community. J Am Board Fam Med. 2006; 19(2):110-21. DOI: 10.3122/jabfm.19.2.110. View

Berkowitz S, Krumme A, Avorn J, Brennan T, Matlin O, Spettell C . Initial choice of oral glucose-lowering medication for diabetes mellitus: a patient-centered comparative effectiveness study. JAMA Intern Med. 2014; 174(12):1955-62. DOI: 10.1001/jamainternmed.2014.5294. View

10.

Silver A, Figge J, Haskin D, Pryor V, Fuller K, Lemme T . An asthma and diabetes quality improvement project: enhancing care in clinics and community health centers. J Community Health. 2010; 36(2):180-90. DOI: 10.1007/s10900-010-9296-8. View

11.

Ostini R, Hegney D, Jackson C, Williamson M, Mackson J, Gurman K . Systematic review of interventions to improve prescribing. Ann Pharmacother. 2009; 43(3):502-13. DOI: 10.1345/aph.1L488. View

12.

Grimshaw J, Thomas R, MacLennan G, Fraser C, Ramsay C, Vale L . Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess. 2004; 8(6):iii-iv, 1-72. DOI: 10.3310/hta8060. View

13.

OBrien M, Rogers S, Jamtvedt G, Oxman A, Odgaard-Jensen J, Kristoffersen D . Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2007; (4):CD000409. PMC: 7032679. DOI: 10.1002/14651858.CD000409.pub2. View

14.

Honigfeld L, Chandhok L, Spiegelman K . Engaging pediatricians in developmental screening: the effectiveness of academic detailing. J Autism Dev Disord. 2011; 42(6):1175-82. DOI: 10.1007/s10803-011-1344-4. View

15.

Feder G, Griffiths C, Highton C, Eldridge S, Spence M, Southgate L . Do clinical guidelines introduced with practice based education improve care of asthmatic and diabetic patients? A randomised controlled trial in general practices in east London. BMJ. 1995; 311(7018):1473-8. PMC: 2543702. DOI: 10.1136/bmj.311.7018.1473. View

16.

Stafford R, Radley D . The underutilization of cardiac medications of proven benefit, 1990 to 2002. J Am Coll Cardiol. 2003; 41(1):56-61. DOI: 10.1016/s0735-1097(02)02670-0. View

17.

Bodenheimer T . Primary care--will it survive?. N Engl J Med. 2006; 355(9):861-4. DOI: 10.1056/NEJMp068155. View

18.

Davidoff F, Haynes B, Sackett D, Smith R . Evidence based medicine. BMJ. 1995; 310(6987):1085-6. PMC: 2549494. DOI: 10.1136/bmj.310.6987.1085. View

19.

Avorn J, Fischer M . 'Bench to behavior': translating comparative effectiveness research into improved clinical practice. Health Aff (Millwood). 2010; 29(10):1891-900. DOI: 10.1377/hlthaff.2010.0696. View

20.

Ricordeau P, Durieux P, Weill A, Chatellier G, Vallier N, Bissery A . Effect of a nationwide program of educational outreach visits to improve the processes of care for patients with type 2 diabetes. Int J Technol Assess Health Care. 2004; 19(4):705-10. DOI: 10.1017/s0266462303000679. View