General practitioners and tutors' experiences with peer group academic detailing: a qualitative study

Frich, Jan C.; Høye, Sigurd; Lindbæk, Morten; Straand, Jørúnd

doi:10.1186/1471-2296-11-12

Cited by 35 publications

(54 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This, combined with an extraordinarily high completion rate (96.5%), a strong clinical relevance experienced by the participating GPs, 36 and the completeness of the prescription data, all strengthen the study results. The fact that an intervention effect was observed for almost all outcome measures contributes further to the validity of the results.…”

Section: Strengths and Limitationssupporting

confidence: 59%

“…Focus group interviews with GPs and PADs after the intervention revealed a positive attitude among GPs to receiving advice and guidance from fellow GPs. 36 The PADs did not consider themselves to be experts, but rather as 'members of the same family', and this, combined with their independence from both the pharmaceutical industry and health authorities, was probably important in obtaining GPs' trust and acceptance. The extra benefits gained by using GPs instead of non-physicians as academic detailing visitors have also been reported in a Dutch study.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Prescription peer academic detailing to reduce inappropriate prescribing for older patients: a cluster randomised controlled trial

Rognstad¹,

Brekke²,

Fetveit³

et al. 2013

Br J Gen Pract

Self Cite

View full text Add to dashboard Cite

BackgroundOlder patients are at particular risk for adverse drug reactions. In older people, interventions targeting potentially inappropriate prescriptions (PIPs) are considered important measures to minimise drug-related harm, especially in the general practice setting where most prescriptions for older patients are issued. AimTo study the effects of a multifaceted educational intervention on GPs' PIPs for older patients. Design and settingThis was a cluster randomised, educational intervention study in Norwegian general practice. Pre-study data were captured from January 2005 MethodEighty continuing medical education (CME) groups (465 GPs) were randomised to receive the educational intervention on GPs' PIPs for older patients (41 CME groups; 256 GPs) or another educational intervention (39 CME groups; 209 GPs); these two groups acted as controls for each other. GPs' prescription data from before and after the intervention were assessed against a list of 13 explicit PIP criteria for patients aged ≥70 years. In the CME groups, trained GPs carried out an educational programme, including an audit, focusing on the 13 criteria and their rationale. ResultsA total of 449 GPs (96.6%) completed the study; 250 in the intervention group and 199 in the control group. After adjusting for baseline differences and clustering effects, a reduction relative to baseline of 10.3% (95% confidence interval = 5.9 to 15.0) PIPs per 100 patients aged ≥70 years was obtained. ConclusionEducational outreach visits with feedback and audit, using GPs as academic detailers in GPs' CME groups, reduced PIPs for older patients aged ≥70 years in general practice.

show abstract

Section: Strengths and Limitationssupporting

confidence: 59%

Section: Strengths and Limitationsmentioning

confidence: 99%

Prescription peer academic detailing to reduce inappropriate prescribing for older patients: a cluster randomised controlled trial

Rognstad¹,

Brekke²,

Fetveit³

et al. 2013

Br J Gen Pract

Self Cite

View full text Add to dashboard Cite

show abstract

“…Options such as selective requests for a second opinion should be tested. These might involve academic detailing (university-based educational outreach involving face-to-face education by trained health care professional) (25-27), which has shown improved performance in physicians’ use of pharmacologic agents.…”

Section: Discussionmentioning

confidence: 99%

Association Between Time Spent Interpreting, Level of Confidence, and Accuracy of Screening Mammography

Carney¹,

Bogart²,

Geller³

et al. 2012

American Journal of Roentgenology

View full text Add to dashboard Cite

Purpose To examine the effect of time spent viewing images and level of confidence on a screening mammography test set on interpretive performance. Materials and Methods Radiologists from six mammography registries participated in the study and were randomized to interpret one of four test sets and complete 12 survey questions. Each test set had 109 cases of digitized four-view screening film-screen mammograms with prior comparison screening views. Viewing time for each case was defined as the cumulative time spent viewing all mammographic images before recording which visible feature, if any, was the “most significant finding”. Log-linear regression fit via GEE was used to test the effect of viewing time and level of confidence in the interpretation on test set sensitivity and false-positive rate. Results 119 radiologists completed a test set and contributed data on 11,484 interpretations. Radiologists spent more time viewing cases that had significant findings or for which they had less confidence in interpretation. Each additional minute of viewing time increased the probability of a true positive interpretation among cancer cases by 1.12 (95% CI: 1.06, 1.19, p<0.001), regardless of confidence in the assessment. Among radiologists who were ‘very confident’ in their assessment, each additional minute of viewing time increased the adjusted risk of a false positive interpretation among non-cancer cases by 1.42 (95% CI 1.21, 1.68), and this viewing-time effect diminished with decreasing confidence. Conclusions Longer interpretation times and higher levels of confidence in the interpretation are both associated with higher sensitivity and false positive rates in mammography screening.

show abstract

“…The Rx-PAD study is one of the largest educational intervention studies undertaken in Norwegian general practice, including approximately 10% of all Norwegian GPs. The study also had an extraordinarily high completion rate (96.5%), and the participating GPs felt that it had strong clinical relevance [54]. These factors, together with the completeness of the prescription data, all strengthen the study results.…”

Section: Discussionmentioning

confidence: 78%

Potentially Inappropriate Prescribing to Older Patients: Criteria, Prevalence and an Intervention to Reduce It: The Prescription Peer Academic Detailing (Rx‐PAD) Study – A Cluster‐Randomized, Educational Intervention in Norwegian General Practice

Rognstad

Brekke

Gjelstad

et al. 2018

Basic Clin Pharma Tox

Self Cite

View full text Add to dashboard Cite

Potentially inappropriate prescriptions (PIP) is drug treatment, which in general, at the group level for a median/mean patient, can be considered unfavourable meaning that the risks commonly may outweigh the benefits. This MiniReview reports and discusses the main findings in a large cluster-randomized educational intervention in Norwegian general practice, aimed at reducing the prevalence of PIPs to patients ≥70 years (The Rx-PAD study). Targets for the intervention were general practitioners (GPs) in continuing medical education (CME) groups receiving educational outreach visits (i.e. peer academic detailing). A Delphi consensus process, with a panel of medical experts, was undertaken to elaborate a list of explicit criteria defining PIPs for patients ≥70 years in general practice. Agreement was achieved for 36 explicit PIP criteria, the so-called Norwegian General Practice (NorGeP) criteria. Using a selection (n = 24) of these criteria during a 1-year baseline period on the prescribing practice of 454 GPs (i.e. those enrolled to participate in the intervention trial), we found a prevalence rate of 24.7 PIPs per 100 patients ≥70 years per year. In the Rx-PAD study, 449 GPs completed an educational intervention (96.6% of the included GPs), 250 in the intervention group and 199 in the control arm. Following the intervention, PIPs were reduced by 13% (95% CI 8.6-17.3), and the number of patients who were no longer exposed to one or more PIPs was reduced by 1173 (8.1%). The GPs who responded most strongly to the educational intervention were the oldest GPs (57-68 years), and these were the GPs with the highest prevalence of PIPs at baseline before the intervention.

show abstract

General practitioners and tutors' experiences with peer group academic detailing: a qualitative study

Cited by 35 publications

References 21 publications

Prescription peer academic detailing to reduce inappropriate prescribing for older patients: a cluster randomised controlled trial

Prescription peer academic detailing to reduce inappropriate prescribing for older patients: a cluster randomised controlled trial

Association Between Time Spent Interpreting, Level of Confidence, and Accuracy of Screening Mammography

Potentially Inappropriate Prescribing to Older Patients: Criteria, Prevalence and an Intervention to Reduce It: The Prescription Peer Academic Detailing (Rx‐PAD) Study – A Cluster‐Randomized, Educational Intervention in Norwegian General Practice

Contact Info

Product

Resources

About