Academic detailing as a method to improve general practitioners' drug prescribing in type 2 diabetes: evaluation of changes in prescribing

Scand J Prim Health Care. 2023 Sep;41(3):224-231. doi: 10.1080/02813432.2023.2222781. Epub 2023 Jun 16.

Abstract

Objective: To investigate the effect of an academic detailing intervention on the utilisation of type 2 diabetes medication among general practitioners.

Design: 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.

Setting and subjects: 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.

Main outcome measures: 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.

Results: 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).

Conclusion: 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.

Keywords: Primary care; academic detailing; antidiabetic drugs; continuing medical education; educational outreach; physician prescribing pattern; type 2 diabetes.

Plain language summary

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.

MeSH terms

  • Diabetes Mellitus, Type 2* / drug therapy
  • Drug Prescriptions
  • General Practitioners*
  • Humans
  • Metformin* / therapeutic use
  • Practice Patterns, Physicians'
  • Sodium-Glucose Transporter 2 Inhibitors*

Substances

  • Sodium-Glucose Transporter 2 Inhibitors
  • Metformin