Academic detailing is an innovative method of service-oriented outreach education for physicians. It provides an accurate, up-to-date synthesis of relevant drug information in a balanced format.
Doctors need an accurate source of current data about the comparative effectiveness, safety, and costs of prescription drugs. This information can be time-consuming to assemble from the research literature, and due to time constraints and competing demands for their time, physicians are often forced to rely on more convenient sources of information.
Pharmaceutical sales representatives, often called “drug detailers” because they provide detailed information about their products, visit physicians in their offices and deliver marketing materials about the products they promote. While the method of delivery is effective, the information is designed with commercial objectives in mind, regardless of whether more effective, safer or less expensive options exist.
Academic detailing is a method of outreach education that combines the interactive, one-on-one communication approach of industry detailers with the evidence-based, noncommercial information of academia. The term “academic detailing” reflects this hybrid concept.
Academic detailing has been utilized in Australia, Canada, the U.K., and the Netherlands to assist prescribers in making optimal prescribing decisions. In 2005, the Pennsylvania Department of Aging’s Pharmaceutical Assistance Contract for the Elderly (PACE) Program launched the first large-scale state academic detailing program in the United States. Recently, multiple states have pursued legislation to begin academic detailing programs in their jurisdictions.
The Independent Drug Information Service is the academic detailing service currently underway in Pennsylvania, Massachusetts, and Washington DC. An independent group of physicians and drug researchers on the faculty of Harvard Medical School comprehensively evaluate medical journals and other data sources to pull together the best available, objective information about drugs used commonly in primary care practice. They then synthesize it into concise, clinically relevant summary documents, decision-making tools, and patient education materials.
Trained pharmacists, nurses, and other health professionals visit with physicians in their offices to discuss clinically appropriate therapeutic choices and patient care practices. Rather than promote particular products, academic detailers provide summaries of the evidence to help physicians prescribe the safest, most effective medications for their patients.
In many cases, the most appropriate therapeutic options are tried and true drugs with safety-risk profiles that demonstrate benefit at relatively lower risk, and because they have been on the market longer, they are often available as affordable generics. This is particularly true in the case of heavily marketed drug classes such as acid-suppressing therapy. But academic detailing is not simply about prescribing generics.
Academic detailing is a quality-driven endeavor that helps physicians make appropriate clinical decisions based on the best available safety, efficacy, and cost-effectiveness data. Because aggressive marketing of high-priced drugs increasingly strains public and private health care budgets, academic detailing has the potential to help control costs while improving patient care and health outcomes, thus aligning the interests of physicians, payers and patients.