title: A pilot study evaluating alternative approaches of academic detailing in rural family practice clinics.
abstract: BACKGROUND
  Academic detailing is an interactive, convenient, and user-friendly approach to delivering non-commercial education to healthcare clinicians. While evidence suggests academic detailing is associated with improvements in prescribing behavior, uncertainty exists about generalizability and scalability in diverse settings. Our study evaluates different models of delivering academic detailing in a rural family medicine setting.
  
  
  METHODS
  We conducted a pilot project to assess the feasibility, effectiveness, and satisfaction with academic detailing delivered face-to-face as compared to a modified approach using distance-learning technology. The recipients were four family medicine clinics within the Oregon Rural Practice-based Research Network (ORPRN). Two clinics were allocated to receive face-to-face detailing and two received outreach through video conferencing or asynchronous web-based outreach. Surveys at midpoint and completion were used to assess effectiveness and satisfaction.
  
  
  RESULTS
  Each clinic received four outreach visits over an eight month period. Topics included treatment-resistant depression, management of atypical antipsychotics, drugs for insomnia, and benzodiazepine tapering. Overall, 90% of participating clinicians were satisfied with the program. Respondents who received in person detailing reported a higher likelihood of changing their behavior compared to respondents in the distance detailing group for five of seven content areas. While 90%-100% of respondents indicated they would continue to participate if the program were continued, the likelihood of participation declined if only distance approaches were offered.
  
  
  CONCLUSIONS
  We found strong support and satisfaction for the program among participating clinicians. Participants favored in-person approaches to distance interactions. Future efforts will be directed at quantitative methods for evaluating the economic and clinical effectiveness of detailing in rural family practice settings.
authors.affiliation: Oregon State University College of Pharmacy, Oregon Health & Science University, Portland, OR, 97239, USA. hartungd@ohsu.edu
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Hartung
authors.forename: Ann
authors.initials: A
authors.lastname: Hamer
authors.forename: Luke
authors.initials: L
authors.lastname: Middleton
authors.forename: Dean
authors.initials: D
authors.lastname: Haxby
authors.forename: Lyle J
authors.initials: LJ
authors.lastname: Fagnan
mesh_terms: D001291:Attitude of Health Personnel; D003258:Consumer Behavior; D020375:Education, Distance / Q000379:methods*; D004502:Education, Medical, Continuing / Q000379:methods*; D005194:Family Practice / Q000193:education*; D005240:Feasibility Studies; D017144:Focus Groups; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D009922:Oregon; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D019035:Rural Health Services