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CADTH » Resources » Academic Detailing Templates » Supporting Information - Appendices » Appendix 2 : ADUP Questionnaire & Follow-Up

Appendix 2 : ADUP Questionnaire & Follow-Up

** Notes and comments from interview in italics **

Needs Assessment and Key Messages

1. Who is responsible for AD topic selection (e.g. committee of practitioners, board of directors, etc.)?

  • Team members (detailers, director, medical advisor) discuss possible topics of current interest to physicians. Literature is reviewed for “gaps” in information, and physicians are asked about what would be of concern to them. Topics are then reviewed for availability of information or resources.. Topics are confirmed by an academic detailing steering committee.

Question: does the provincial health program have influence on chosen topics? If so, where in the topic selection process?

  • No. Internal search first. Discuss with family physicians on steering committee in Calgary and Edmonton. Then do formal care gap analysis, then bring to overall committee. AB health and wellness has one representative on the overall steering committee.

Question: how are physicians “asked” about topics? Is there a formal survey?

  • Physicians on steering committee. Ad hoc survey will be taken if required.

2. What process is used to select AD topics? In other words what, if any, formal “Needs Assessment” is conducted to determine an AD topic?

  • Topics must be relevant to front line providers (physicians have expressed an interest to the detailers or impact a large number of patients – a large burden of disease), have up to date guidelines or information from other sources, medications are the mainstay of the treatment, significant variations or deficiencies are known to exist in usual care, education deficiencies are a likely cause of variations or deficiencies and the effects of intervening are measurable.

Question: how are “significant variation or deficiencies are known to exist in usual care”, literature, survey, provincial database information?

  • Both literature search, asking family physicians and specialists within the area.

3. Once a topic is chosen, who is responsible for development of “Key Message”?

  • One of the detailers develops key messages, based on physician interview questions and review of “grey” literature.

Question: is this a formal physician interview process or similar to the process used in topic selection?

  • Same as above.

4. What process is utilized, or what considerations are made, when developing “Key Messages”? (E.g. does each key message have to result in a measurable outcome?)

  • A gap in information exists, outcomes are measurable and obtainable.
  • The impact of key messages may be related to changes in prescribing behavior ie has there been an increase in prescribing of a certain medication (targeted in one of the key messages) after the detailing session.

5. Do you have a set number of key messages for each topic, or can any number of messages be chosen?

  • Maximum 3

Academic Detailer Training and Background Material

1. Who is responsible for training Academic Detailers on an AD topic?

  • Training is mainly self directed study of identified articles, CPG, etc., in coordination with medical advisor.

Question: please explain, does the medical advisor produce a listing of materials that should be reviewed?

  • Information is collated and binder is created. This material is identified and collated by one the detailers. The medical advisor sits in on the training process but doesn’t input on the production of the “binder”. Providing outline of RTI binder table of contents.

2. How is Detailer training conducted (e.g. group tutorials, teleconference training, etc.)? Where is the training held and how long does training usually take?

  • Combinations of study, teleconferences; Use of “library club” concept – articles are assigned to team members for critique; Formal training as a group over 1-2 days, such as session(s) together at main office.

Question: What is involved in the “formal training”? Are all detailers expected to attend or are they linked in through technology? Everyone comes to Edmonton for training

3. What materials are routinely involved in the training of Academic Detailers (e.g. power point presentations on topics)? Please provide examples of training materials employed by your organization in Detailer training.

  • Materials such as relevant articles, summaries of medications (“FastFact” references developed by detailers), CPGs, information from other expert organizations, health region materials, etc. are brought together in binder format, updated as topic progresses. No powerpoint or other AV materials
  • See also #4 below

4. What background materials or support materials on an AD topic are provided to detailers to ensure they are well enough versed in the topic to conduct physician visits (e.g. detailed summary documents, primary literature, etc.)? Please provide examples of materials developed by your program that act as background or support materials for detailers.

  • See attached:
    • Adultcap_final_mar7
    • fastFACTS_Macrolides
    • Pneumonia_Key Messages_final
    • Newsletter 7 DUR JAN04 urti
    • Pneumonia Guidelines_Summary Table_Diagnosis_v1_detailers
    • Pneumonia Guidelines_Summary Table_Empiric Therapy_Antibiotics_v1_detailers

Question: what of these materials are provided to the physician directly and what are exclusively utilized by the detailers?

  • None of this material is provided directly to physicians. Too rough. The Newletter 7 DUR Jan04 URTI not sent to physicians, old.

5. Do you conduct any type of knowledge assessment or testing of detailers to assess the effectiveness of training for AD topics?

  • No.

6. Are there any mechanisms put into place within your organization to provide ongoing support to Detailers on a specific AD topic (e.g. access to clinical experts for follow-up questions, etc.)?

  • Access to medical advisor, management committee, physicians in chronic disease management through one lead detailer

Question: describe the process for accessing medical advisors, management committee or physicians in CD management.

  • One med advisor works for ADUP, accessed as needed. Other specialists accessed through single advisors in individual regions (ex. Calgary HR.)

Academic Detailing Material for Primary Care Practitioners

1. Who is responsible for the production of AD materials in your organization (e.g. internal staff, contract experts, etc.)?

  • Alberta Medical Association, Towards Optimized Prescribing group produces guideline summaries, supplemental materials are developed internally

Questions: Specifically who produces FastFacts, Newsletter, are they all considered supplemental materials?

  • Paula works with clinical experts in Calgary, family physicians and TOP program to produce materials that physicians see (main detailing pieces – ex. risk calculator, newsletter). All other materials FastFacts etc. done internally.

2. Briefly describe the types of AD materials produced by your organization, and provide examples of the materials. If possible, please categorize the AD materials you produce into one of the following groups:

Newsletters

Prescribing Aids (e.g. titration guides, quick reference cards, reference charts)

Patient Materials

(Note: as this material is of primary interest to COMPUS, please provide as many examples as possible)

  • Resources developed are in coordination with organization like TOP summaries, primary study articles. Patient handouts from organizations like Calgary Chronic Disease Management or Do Bugs Need Drugs. Please provide .pdf if available.
  • Newsletters: see Newsletter 5, 7, 10 as examples
  • Dyslipidemia Clinical Notes Summaries – not a newsletter, a follow-up document developed based on questions from physicians
  • Prescribing aids : see Dyslipidemia_Risk_Calculator_TOP final

Question: Discuss difference between Newsetter 7 and 10. 7 deals with a DUR identifying practice deficiency where 10 describes impact of evaluation. What material was used to cause change in practice outlined in osteoporosis newsletter.

3. Is there any standard formatting or branding used in the AD materials your organization produces?

  • ADUP logo usually with Alberta Medical Association logo. Always use 2-page laminated PEM form. Always has similar font. Sending Pneumonia and any others she can acquire.

4. How are AD materials utilized during an AD intervention (e.g. are all materials brought by detailer or are some materials mailed out ahead of time)?

  • Materials are brought by detailer at time of session, others may be sent at followup. Detailers also provide continuing education information and prescribing feedback reports to physicians at visits.

Question: please describe these continuing education information (is this CE forms that they can send in)? Did CME event before the actual detailing visits, copies of the CME DVD available to physicians if they wanted it. If participated with the AD + CME, available for MAINPRO accreditation.

  • Physicians can receive a prescribing feedback forms. Consent forms signed during the visit. Reports generated 6 months after intervention.

5. Are there AD materials you would like to produce or have access to that you currently do not? What barriers are there to the production of these materials?

  • Unknown what materials would be produced– barriers include budget, time (long term plan)
  • Don’t want to provide too much information. Would like to see better quality materials vs. more materials. Implement suggestions of design people

Impact Evaluation

1. Describe the types of Impact Evaluation conducted by your organization to assess the effectiveness of an AD intervention. If reports of Impact Evaluation are available, please provide. Please also include any examples of informal evaluation, surveys or evaluation efforts that are still in process.

  • Impacts are evaluated by comparative prescribing feedback reports from Alberta Blue Cross (direct to physicians). Physicians fill out short evaluation of visit, information presented, detailer behavior, which are summarized. Can be faxed or mailed in. Detailers fill out one (time and motion data), which key messages etc. The 3rd component, looking at the detailed physicians vs control to see changes in prescribing behavior. Data for dyslipidemia was being collated when program cut.
  • See:
  1. 2005 Internal Evaluation Osteoporosis v3
  2. AMCDU ADUP Final Report July 4 05
  3. Prescriber Feedback Report osteo 30JUL04
  4. Anti-infdursreportversion 9 12NOV03 JK

2. What data sources, if any, must be accessed to conduct the Evaluation (e.g. provincial drug databases, “linked” healthcare databases)?

  • The Alberta Blue Cross Group 1, 66 and 66A (provincial drug program) databases, Alberta Health and Wellness archive tapes (assessment of drug claims), with links to physician diagnosis codes, lab test requests, hospitalizations

3. Who conducts the Impact Evaluation (e.g. conducted by persons within the organization or by external evaluators such as government)?

  • Evaluation done within organization every 3 years [See AMCDU ADUP Final Report July 4 05]

Questions about application of COMPUS material:

What types of material are you expecting from COMPUS?

  • Material discussed in Vancouver. Training materials, as well as actual detailing materials. The training takes a lot of time, so that would be a leap forward. As well the primary information to get detailers started.

How are you envisioning these materials to be utilized in your particular AD organization? Would materials have to be reviewed by local advisors?

  • Have to be reviewed with local stakeholders, get buy-in and support.

Would you want to be able to “brand” the materials with your own logo, as well as the COMPUS logo?

  • Ideally yes, but could get around this by putting in ADUP folder or other ways.