Purpose: The message of a paradigm shift in the treatment of rheumatoid arthritis (RA) to early, aggressive and sustained use of Disease Modifying Anti-Rheumatic Drugs and treating to target remission, has not yet reached all Family Physicians (FPs) in Canada. A promising technique to optimize FP practice is Academic Detailing (AD) which involves visits by trained health care professionals to physicians in their offices, providing evidence-based information on a selected topic. The objective of our study was to understand FPs’ perceptions about the feasibility, acceptability, and utility of AD to provide information about RA management.
Methods: We conducted one-on-one semi-structured telephone interviews with twelve consecutive FPs who participated in an AD intervention for RA and who agreed to be interviewed. Interview transcripts were analyzed using a qualitative descriptive approach with inductive content analysis.
Results: FPs reported appreciating AD for its educational value, convenience, one-on-one interaction, short duration; subject expert input in content, and practical, evidence-based and focused content. Some FPs identified disadvantages, such as difficulty incorporating AD during work days, lack of dedicated CME time, insufficient time for detailed discussions, lack of time to consult information left behind and standardization of the message delivered. AD was acceptable to most FPs, who reported perceived benefits of the visits, including improved confidence in managing RA, anticipating clinical practice changes and willingness to receive AD in the future.
Conclusion: Participating FPs perceived AD as a feasible, acceptable and useful CME technique to receive information about RA management aimed at optimizing care.
Harpreet Chhina, Wendy Hall, Janusz Kaczorowski, Carlo Marra, Diane Lacaille