Academic Detailing

Why this strategy works

The purpose of commercial detailing, the sales strategy upon which academic detail is based, is the targeted marketing of pharmaceutical products to healthcare providers who are best positioned to prescribe them, which, depending on state law, includes physicians, physician assistants, nurse practitioners, and pharmacists. Academic detailing takes the most effective practices of this commercial marketing and applies them to the “marketing” of evidence-based practices to healthcare providers and other community stakeholders. In the context of overdose prevention efforts, academic detailing has been used to assist physicians in reducing potentially risky opioid prescribing practices, to prepare pharmacists to effectively distribute naloxone to the public, and many other innovative and community-based
initiatives designed to deliver new skills to those individuals poised to make an impact on the rate of overdose in their communities.

Academic detailing works best when:

• Dedicate and trained detailing teams are deployed for all academic detailing activities as this strengthens the detailing approach and fosters consistency within the project.
• The individuals who receive academic detailing possess the means and resources to put their newly gained knowledge to use. For instance, physicians who treat patients receiving opioid prescribing requires additional patient follow-up activities and administrative tasks.

• A recent review found that commercial detailing is so effective in prompting behavior change among healthcare providers that its effects are overpowering those of traditional academic information sources. One major factor behind this pattern is that researchers who produce and seek to disseminate scientific medical knowledge are rarely trained in effective communication strategies. Academic detailing corrects this disparity by "marketing" new science to healthcare providers in a compelling and efficacious manner.
• Academic detailing has been used to improve physician practices across a variety of medical spheres, including opioid prescribing, proper medication dosing for patients with limited renal function, and the timely screening of pregnant women for high-risk infections.
• In a recent study on the effects of academic detailing on general practitioners, those who received detailing significantly improved their clinical management of refractory labored breathing. Further, more than 80% of those physicians who did not receive detailing lacked confidence in their knowledge of and ability to manage this condition.

• A 2013 overdose prevention intervention carried out on Staten Island used targeted educational sessions with medical providers to reduce rates of inappropriate opioid prescribing and overdose death. The intervention resulted in a 29% decrease in prescription opioid overdoses on Staten Island, even as overdose rates remained unchanged in New York City’s other boroughs.
• Recent efforts to increase the rate of naloxone prescription by general practitioners through academic detailing have shown remarkable results. A study in San Francisco found an eleven-fold increase in the rate of naloxone prescription among physicians who received a half-hour long academic detailing session. Further, a large scale academic detailing effort in the Veterans Health Administration was able to reach more than 7,000 physicians in less than a year.46 This effort resulted in a threefold increase in naloxone prescription one year after the intervention and a seven-fold increase two years later, indicating that physicians were enabled to improve their clinical practice independently even after the academic detailing had taken place.