KUPP - The Norwegian Academic Detailing Program. Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim University Hospital, P.O.Box 3250 Torgarden, 7006, Trondheim, Norway.
Section for Drug Safety, Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
BMC Prim Care. 2023 Mar 27;24(1):84. doi: 10.1186/s12875-023-02040-6.
One measure to support optimal opioid prescription is academic detailing (AD) with one-to-one visits by trained professionals (academic detailers) to general practitioners (GPs).
To investigate the usefulness of AD visits on GPs' opioid prescribing patterns in Norway, and academic detailers' experiences with AD visits to GPs on opioid prescription.
Design: A quantitative registry study on opioid prescriptions and a qualitative focus group interview study with academic detailers.
For the registry study, municipalities where more than 75% of the GPs had received an AD visit were considered intervention municipalities, whereas in the non-intervention municipalities no GPs had received AD-visits. In the focus groups, academic detailers who had conducted three or more AD-visits were invited to participate.
A campaign on opioid prescription with AD visits using a brochure with key messages based on the national guideline for treatment of chronic non-cancer pain and updated evidence on the potential benefits and risks of prescribing opioids. The AD visits in the campaign were planned for 20-25 min in a one-to-one setting in the GP's office.
The Norwegian Prescription Database (NorPD) was utilized for registry data. Data on amount of drugs dispensed are recoded as Defined Daily Doses (DDDs).
Compared to non-intervention, the intervention resulted in a decrease in the number of prevalent and incident users of opioids and incident users of reimbursed opioids for chronic non-cancer pain in municipalities in Central Norway. The results from the focus group interviews were categorized into the themes: "To get in position", "Adjusting messages", "What did the GPs struggle with, in relation to opioid prescription?" and "Did we reach the right recipients with the visits?".
In Central Norway, the intervention resulted in a desired effect on number of opioid users. According to the academic detailers, the GPs' length of working experience and familiarity with the topic gave different presumptions for making use of the information presented in the AD-visits.
支持优化阿片类药物处方的一种措施是由经过培训的专业人员（学术详细信息员）对全科医生（GP）进行一对一的访问，即学术细化（AD）。
调查挪威 AD 访问对 GP 阿片类药物处方模式的有用性，以及学术详细信息员对 GP 阿片类药物处方 AD 访问的经验。
设计：对阿片类药物处方的定量登记研究和对进行了三次或更多次 AD 访问的学术详细信息员的定性焦点小组访谈研究。
对于登记研究，认为接受 AD 访问的 GP 超过 75%的市为干预市，而未接受 AD 访问的市为非干预市。在焦点小组中，邀请进行了三次或更多次 AD 访问的学术详细信息员参加。
使用基于国家治疗慢性非癌性疼痛指南和更新的阿片类药物处方潜在益处和风险证据的宣传册进行阿片类药物处方 AD 访问的宣传活动。该活动中的 AD 访问计划在 GP 办公室的一对一环境中进行 20-25 分钟。
利用挪威处方数据库（NorPD）获取登记数据。药物剂量的记录数据被重新编码为规定日剂量（DDD）。
与非干预相比，在挪威中部的市，干预导致慢性非癌性疼痛的现患和新发阿片类药物使用者以及新发报销阿片类药物使用者的数量减少。焦点小组访谈的结果被归类为以下主题：“做好准备”、“调整信息”、“GP 在阿片类药物处方方面遇到了哪些困难？”和“我们是否通过访问找到了正确的对象？”。
在挪威中部，干预对阿片类药物使用者的数量产生了预期的效果。根据学术详细信息员的说法，GP 的工作经验长度和对主题的熟悉程度为利用 AD 访问中提供的信息提供了不同的假设。
