Academic Detailing Compared with Group Meetings to Change Drug Prescribing for Type 2 Diabetes—A Randomized Controlled Trial

Background

Academic detailing (AD) is a one-on-one educational outreach with the goal to improve prescribing. There is insufficient evidence on the difference in impact between AD and group visits to facilitate behavior change among general practitioners (GPs).

Objective

To compare the impact of individual AD visits and group visits conveying the same content on treatment of type 2 diabetes (T2D).

Design

Randomized controlled trial.

Participants

GPs in Central Norway, visited September – November 2018.

Intervention

A total of 210 GPs were randomized and invited to an individual AD visit lasting 20 min; 193 were visited, of whom 146 were included in the analyses. In addition, 293 GPs were randomized and invited to a group meeting lasting 30–45 min; 261 were visited, of whom 188 were included in the analyses. Finally, 167 GPs were randomized and included in a control group. Visits were conducted by trained pharmacists and physicians.

Main Measures

Changes in prescribing of metformin and other T2D drugs after the intervention.

Key Results

The use of metformin increased with 5.9% the year after AD and with 4.9% the year after group meetings, compared to no change (0.0%) in the control group (p = 0.006 and p = 0.016, respectively). There was no significant difference between the two intervention groups. The only drug group with a statistically significant difference between interventions was insulins, with an increase of 3.2% after AD compared to 19.1% after group visits (p < 0.001). For GLP-1 analogues (p = 0.031) and T2D drugs in total (p = 0.010), we found a significant difference between group intervention and control. Other differences between study groups did not reach statistical significance.

Conclusions

Short educational visits of 20–45 min impact the prescribing of drugs for T2D, either the education is given one-on-one as AD or in a group setting.