학술논문

Academic detailing as a method to improve general practitioners' drug prescribing in type 2 diabetes: evaluation of changes in prescribing.
Document Type
Article
Source
Scandinavian Journal of Primary Health Care. Sep2023, Vol. 41 Issue 3, p224-231. 8p.
Subject
*DRUG standards
*ATTITUDES of medical personnel
*SULFONYLUREAS
*PRIMARY health care
*TYPE 2 diabetes
*COMPARATIVE studies
*INAPPROPRIATE prescribing (Medicine)
*DRUG prescribing
*DESCRIPTIVE statistics
*PHYSICIAN practice patterns
*MEDICAL prescriptions
*DRUG utilization
*METFORMIN
*SODIUM-glucose cotransporter 2 inhibitors
*EDUCATIONAL outcomes
*PATIENT safety
Language
ISSN
0281-3432
Abstract
To investigate the effect of an academic detailing intervention on the utilisation of type 2 diabetes medication among general practitioners. We developed an academic detailing campaign based on the revised national treatment guideline for diabetes and the best available evidence. General practitioners were offered a 20-minute one-to-one visit by a trained academic detailer. A total of 371 general practitioners received a visit and represented the intervention group. The control group consisted of 1282 general practitioners not receiving a visit. Changes in prescribing from 12 months before to 12 months after the intervention. The primary endpoint was a change in metformin. Secondary endpoints were changes in other groups of Type 2 diabetes medication and of these drugs in total. Prescribing of metformin increased by 7.4% in the intervention group and 5.2% in the control group (p =.043). Sodium-glucose cotransporter-2 inhibitors increased by 27.6% in the intervention group and 33.8% in the control group (p =.019). For sulfonylureas there was a decrease of 3.6% in the intervention group vs. 8.9% in the control group (p =.026). The total amount of prescribed medications for type 2 diabetes increased by 9.1% in the intervention group and 7.3% in the control group (p =.08). Academic detailing initiated a small but statistically significant increase in the prescription of metformin. For a complex subject like type 2 diabetes, we recommend reserving more time in the visit than the 20 min our campaign aimed for. Academic detailing is a validated method for facilitating changes in prescribing, via interactive one-to-one meetings with a trained academic detailer. General practitioners who received a 20-minute visit on the treatment of type 2 diabetes prescribed more metformin, compared to the control group. For a complex interventions like the present, we recommend setting aside more than 20 minutes, to ensure sufficient time for discussion and reflection. Academic detailing can impact prescribing, even for a complex subject like the treatment of Type 2 Diabetes. [ABSTRACT FROM AUTHOR]