Educational outreach (academic detailing) regarding osteoporosis in primary care.
BACKGROUND
Academic detailing utilizes educators trained in social marketing to conduct one-on-one visits with physicians using evidence-based data. Academic detailing programs have improved physician's prescribing behaviors; however, the feasibility of large-scale programs across a large, geographically disperse state is unclear.


METHODS
The study team collaborated with a state-run pharmacy benefits program for low-income elderly in a trial to improve osteoporosis management. Community-practicing physicians who saw a minimum of 25 patients enrolled in the benefits program were randomized to receive academic detailing or not. Fourteen educators were trained in the principles of academic detailing as well as osteoporosis epidemiology, diagnosis, and treatment. From September 2003 to January 2004, they attempted to meet with physicians or an allied health professional to discuss osteoporosis and fracture prevention.


RESULTS
The physician population was 356 and 148 (41.6%) visits were completed-100 with physicians, 38 with allied health professionals, and 10 with both the physician and an allied health professional. In mixed multivariable models, there were no physician characteristics associated with completed encounters, including gender, training, geographic location, years since medical school, and number of study patients (all p-values > 0.11). The detailer's gender, professional training, and professional experience were not statistically significant correlates of completed encounters (all p-values > 0.28). Number of years since a detailer's professional training was a predictor of a completed encounter, OR = 1.43 per 5 years (95%CI 1.05, 1.96).


CONCLUSIONS
A moderate rate of completed encounters was achieved. There was only one predictor of completed encounters.
Polinski
Jennifer M
JM
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120, USA. jpolinski@partners.org
Brookhart
M Alan
MA
Katz
Jeffrey N
JN
Arnold
Marilyn
M
Kristeller
Judy
J
Trombetta
Dominick
D
Tadduni
Mary Elizabeth Doyle
ME
Golomb
Mary Jean
MJ
Solomon
Daniel H
DH
D000488:Allied Health Personnel; D004502:Education, Medical, Continuing; D005260:Female; D040441:Health Educators; D006801:Humans; D008297:Male; D008483:Medical Assistance; D010024:Osteoporosis / Q000188:drug therapy / Q000517:prevention & control; D010414:Pennsylvania; D010820:Physicians; D011320:Primary Health Care