How and why academic detailing works to improve clinical decision-making

• A Government-funded public health improvement program from the pharmacy department of an acute care geriatric teaching hospital
• Serving South Australian primary and secondary care practitioners since 1991
• Regular visits to ~1100 doctors every six to nine months
• Personalized therapeutic advice services during and between visits
• >90% of all Primary Care Doctors in the State
• Topics covered include
• Disease management issues
• Prescribing issues
• Preventive care issues
• Quality of care issues

Academic detailing programs are extensively used in other countries, particularly in Australia and Canada. While there are important differences between those healthcare systems and that of the United States, it is important to note that U.S. prescription drugs are generally considerably more costly. That may suggest the potential for even greater savings here. In Australia, the National Prescribing Service program generated net savings of 300 million Australian dollars over ten years. This is largest, longest running program in the world, involved 11,500 individual prescribers in 2006-2007 (a steady increase from 2,500 participants in 1998–99. Over a nearly ten-year period 1997-2005), estimated savings have consistently been greater than budgeted.
Dr. Frank May is one of members who established Academic detailing programs in Australia. We invited him as the speaker in the symposium we held last year.

The First Academic Detailing Conference

Academic detailing is personalized support for improving both knowledge and clinical decision-making by the latest non-commercial evidence-based data.　First Academic Detailing Conference was held last 2013 at Boston, USA. Many world’s eyes focus on Academic Detailing lately.
Doctors select mainly best medicine through viewpoint of experiences and clinical guidelines to prescribe patients (Fig.1). Pharmacists select mainly best medicine through viewpoint of drug characteristic such as pharmacological action, physical chemistry characteristic and metabolite mechanism. Furthermore, pharmacists also require to provide medical teams with the latest information including molecular pharmacology, genome information and others. Our university is traditionally fulfilling basic pharmaceutical sciences.

However, our pharmacist education program utilizing basic pharmaceutical sciences for patients is definitely not enough to be a highly qualified clinical pharmacist. Therefore, we focus on utilizing basic pharmaceutical sciences and established division of Academic Detailing Database in our University. Eight essential fields which are necessary to support Doctor’s prescription are Biology, Chemistry, Physics, Pharmacology, Pharmaceutics, Pharmacotherapy, Clinical Guideline and Drug Adverse Reaction (Fig.2).

Our aim is to integrate these data in order to develop original diversified. Academic Detailing Database. Then we would be able to propose a doctor the most appropriate medicine for a patient by using it. First, we focused on breast cancer treatment and started to develop the Pharmaceutics database last year (Fig.3). The new program which is to utilize Academic Detailing Database for patient was also tested. In the future, we will expand into several diseases and release the database to all pharmacists in Japan.

Future Development Goals

We will try to make the database related to breast cancer first. In the future, we hope to expand into several diseases and release the Academic Detailing Database to all pharmacists in Japan.

Message

In this Division, we established in April, 2014. Our pharmacist education program utilizing basic pharmaceutical sciences for patients is still not enough to be a highly qualified clinical pharmacist. Therefore, we focus on utilizing basic pharmaceutical sciences and established division of Academic Detailing Database in our University.