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General practitioners and tutors' experiences with peer group academic detailing: a qualitative study
Jan C Frich1, Sigurd Høye, Morten Lindbaek
1Section for General Practice, Institute of Health and Society, University of Oslo, Blindern, N-0318 Oslo, Oslo, Norway. j.c.d.frich@medisin.uio.no
BMC Family Practice
|February 16, 2010
Summary
Peer academic detailing improved general practitioners' (GPs) pharmacotherapy competence and prescribing practices. Individual feedback motivated reflection, though unfavorable results could cause distress, requiring tutor preparedness.
Area of Science:
- Medical Education
- Pharmacotherapy
- General Practice
Background:
- The Prescription Peer Academic Detailing (Rx-PAD) project is an educational intervention designed to enhance general practitioners' (GPs) pharmacotherapy skills.
- GPs were randomized into Continuing Medical Education (CME) peer groups receiving tailored interventions for safer prescribing in elderly patients or improved antibiotic prescribing for respiratory infections.
Purpose of the Study:
- To explore GPs' and tutors' experiences with peer group academic detailing.
- To identify GPs' reasons for deviating from recommended prescribing practices.
Main Methods:
- Nine focus group interviews were conducted with 39 GPs and 20 tutors.
- Interview transcripts were analyzed using thematic content analysis by two researchers.
Main Results:
- Shared understanding of prescribing decision-making was crucial for open CME group discussions.
- Individual feedback motivated GPs to reflect on and improve prescribing, but unfavorable reports could cause distress.
- Reasons for inappropriate prescriptions included lack of knowledge, patient factors, GP background, practice issues, and external healthcare influences.
Conclusions:
- Peer group academic detailing is a suitable method for discussing and learning pharmacotherapy.
- GPs became more reflective about their prescribing habits.
- Tutors need to be prepared to manage potential distress arising from disclosure of inappropriate prescribing.
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