Randomised trial of intensive academic detailing to promote opportunistic recruitment of women to cervical screening by general practitioners.
OBJECTIVE
To evaluate a multifaceted intervention involving intensive academic detailing for general practitioners (GPs) to improve recruitment of women for cervical screening.


METHODS
We conducted a cluster randomisation trial involving 39 general practices in inner-metropolitan Sydney. GPs' knowledge, propensity to an opportunistic approach, competence and confidence were assessed by self-report before and after the intervention. To measure GP behaviour, recall of an opportunistic discussion about cervical screening was determined in cross-sectional samples of female patients at baseline (n = 1,090) and post-test (n = 1,062).


RESULTS
Knowledge improved marginally in both groups but there were no changes in other GP self-reported measures. At post-test, women attending GPs in the intervention group were no more likely than those in the control group to recall an opportunistic inquiry about their cervical screening status (OR 0.65, 95% CI 0.40-1.08). Women in the intervention group who were overdue for cervical screening were no more likely than their control group counterparts at post-test to recall advice about cervical screening (OR 2.16, 95% CI 0.75-6.14) or written information (OR 0.34, 95% CI 0.04-26.5).


CONCLUSIONS
Intensive academic detailing does not improve an opportunistic approach to cervical screening in general practice.


CONCLUSIONS
In an evidence-based climate, implementation of academic detailing as a strategy to improve cervical screening rates in general practice would be premature.
Young
Jane M
JM
Surgical Outcomes Research Centre, Central Sydney Area Health Service, School of Public Health, University of Sydney, New South Wales. jyoung@email.cs.nsw.gov.au
Ward
Jeanette E
JE
D000328:Adult; D000368:Aged; D001315:Australia; D016022:Case-Control Studies; D003954:Diagnostic Services; D003944:Diagnostic Techniques, Obstetrical and Gynecological; D005260:Female; D006293:Health Promotion; D006801:Humans; D008875:Middle Aged; D018579:Patient Selection; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears