Chester County Medicine Spring 2021 - 7

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" Marketing " clinical evidence
in an accessible, user-friendly way
MICHAEL FISCHER, MD, MS, IS PRINCIPAL INVESTIGATOR OF THE AHRQ-SUPPORTED NATIONAL RESOURCE CENTER ON
ACADEMIC DETAILING AND ASSOCIATE PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL
&
PAUL FANIKOS, R.PH., MPA/HA, IS THE CHIEF OPERATING OFFICER AT ALOSA HEALTH

I

n the late 1970s and early 1980s, it was clear that new
evidence about how to prescribe medications and treat
patients was being published at a very rapid rate, with dozens
of new studies published each month. At that rate, even the
most conscientious doctor would not have the time to read and
evaluate all of this new information while also keeping up with the
demands of clinical practice and might instead get information
about new tests or treatments from sales representatives and end
up making decisions based on incomplete sources of information
or with a skewed view of the data.
Recognizing these challenges,
Jerry Avorn, MD, Professor of
Medicine at Harvard Medical School,
pioneered the concept of academic
detailing in the early 1980s. He
and his team generated pragmatic
recommendations for the treatment
of common conditions, based only
on the latest evidence on what was
most effective and safest for patients.
However, instead of presenting these
recommendations in dry continuing
education lectures or lengthy journal articles, they adopted the
communication strategies that had been so effective for the
drug-company detailers. They hired pharmacists and trained
them in social marketing, a direct outreach education approach.
These trained academic detailers visited doctors in their offices
to present the evidence-based recommendations interactively,

backed up by brief, engaging documents that gave doctors specific
recommendations about how to improve the care of their patients.
Doctors welcomed this new source of unbiased information,
and rigorous review of actual prescribing data showed that it did
improve prescribing, leading to more rational use of antibiotics and
reduced use of dangerous painkillers and sedatives in vulnerable
elderly patients. Since those original studies, academic detailing has
been evaluated in over 100 additional trials in outpatient offices,
nursing homes, and inpatient hospital wards all over the world,
where it has been clearly proven effective at improving patient care.
Nationally academic detailing is no longer regarded as a subject
in need of more research, it is considered a proven evidence-based
method of disseminating medical information that results in
behavioral change among clinicians.
Pennsylvania has always been a leader with adapting
innovation and in 2004 the Pennsylvania Department of Aging's
Pharmaceutical Assistance Contract for the Elderly (PACE)
worked with Alosa Health, a 501(c)(3) not-for-profit organization,
to develop educational modules and provide academic detailing
visits to front-line clinicians. Since that time, over thirty thousand
visits have been completed across the state, covering more
than twenty-five clinical topics to clinicians who serve PACE
cardholders. Meeting prescribers " where they are, " addressing their
individual needs, and developing personal relationships creates
a trusting environment to deliver effective education that results
in positive practice change. Interactivity and personalization help
explain why academic detailing has been so effective in changing
medication use - far more so than conventional methods of
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SPRING 2021 | CHESTER COUNT Y Medicine 7
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Chester County Medicine Spring 2021

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