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Professional Intervention: Educational outreach visits


Use of a trained person who met with providers in their practice settings to give information with the intent of changing the provider's practice. The information given may have included feedback on the performance of the provider(s). Can also be referred to as "academic detailing".


Five high quality reviews (Faulkner, Forsetlund, Nkansah, O'Brien, Thomas) and three key reviews (Arnold, Davey, Shaw) were identified. In two high quality reviews (Nkansah, O'Brien) educational outreach visits were generally effective for improving appropriate care and prescribing behaviours, while the results from one key review (Arnold) indicated mixed effects for this intervention. Three high quality reviews (Faulkner, Forsetlund, Thomas) and two key reviews (Davey, Shaw) had an insufficient number of studies to draw conclusions about the effectiveness of this intervention.

Summary of Overall Findings from Reviews

34 reviews that evaluated the effectiveness of educational outreach visits were identified. Of these, 2/3 high quality/key reviews with a sufficient number of studies to draw conclusions found this intervention to be generally effective.

Summary of Findings Related to Prescribing

2/3 high quality/key reviews with a sufficient number of studies to draw conclusions found this intervention to be generally effective for improving prescribing outcomes.

Reviews listed as "Summary Pending" will be analyzed, summarized and reported at a later date.

The findings will then be incorporated in the overall evidence summaries of the interventions they address.

Reviews Addressing This Intervention Quality Assessment Tool:
AMSTAR Score (of 11 points)
Nkansah N, Mostovetsky O, Yu C, Chheng T, Beney J, Bond C, Bero L. Effect of outpatient pharmacists' non-dispensing roles on patient outcomes and prescribing patterns. Cochrane Database of Systematic Reviews 2010 7:CD000336. 9 (High)
Richter T, Meyer G, Mohler R, Kopke S. Psychosocial interventions for reducing antipsychotic medication in care home residents. Cochrane Database of Systematic Reviews 2012 12:CD008634. 9
Summary Pending
Faulkner A, Mills N, Bainton D, Baxter K, Kinnersley P, Peters TJ, Sharp D. A systematic review of the effect of primary care-based service innovations on quality and patterns of referral to specialist secondary care. The British Journal of General Practice 2003 53 (496):878-84. 8 (High)
Forsetlund L, Bjorndal A, Rashidian A, Jamtvedt G, O'Brien MA, Wolf F, Davis D, Odgaard-Jensen J, Oxman AD. Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2009 2:CD003030. 8 (High)
Ivers N, Jamtvedt G, Flottorp S, Young JM, Odgaard-Jensen J, French SD, O'Brien MA, Johansen M, Grimshaw J, Oxman AD. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews 2012 6:CD000259. 8
Summary Pending
O'Brien MA, Rogers S, Jamtvedt G, Oxman AD, Odgaard-Jensen J, Kristoffersen DT, Forsetlund L, Bainbridge D, Freemantle N, Davis DA, Haynes RB, Harvey EL. Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2007 4:CD000409. 8 (High)
Thomas L, Cullum N, McColl E, Rousseau N, Soutter J, Steen N. Guidelines in professions allied to medicine. Cochrane Database of Systematic Reviews 2000 2:CD000349. 8 (High)
Akbari A, Mayhew A, Al-Alawi MA, Grimshaw J, Winkens R, Glidewell E, Pritchard C, Thomas R, Fraser C. Interventions to improve outpatient referrals from primary care to secondary care. Cochrane Database of Systematic Reviews 2008 4:CD005471. 7 (Medium)
Arnold SR, Straus SE. Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database of Systematic Reviews 2005 4:CD003539. 7 (Medium)
Davey P, Brown E, Fenelon L, Finch R, Gould I, Hartman G, Holmes A, Ramsay C, Taylor E, Wilcox M, Wiffen P. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database of Systematic Reviews 2005 4:CD003543. 7 (Medium)
Forsetlund L, Eike MC, Gjerberg E, Vist GE. Effect of interventions to reduce potentially inappropriate use of drugs in nursing homes: a systematic review of randomised controlled trials. BMC Geriatrics 2011 11:16. 7
Summary Pending
Marinopoulos SS, Dorman T, Ratanawongsa N, Wilson LM, Ashar BH, Magaziner JL, Miller RG, Thomas PA, Prokopowicz GP, Qayyum R, Bass EB. Effectiveness of continuing medical education. Evidence Report/Technology Assessment 2007 (149):1-69. 7 (Medium)
McKibbon KA, Lokker C, Handler SM, Dolovich LR, Holbrook AM, O'Reilly D, Tamblyn R, Hemens BJ. Basu R. Troyan S. Roshanov PS. Archer NP. Raina P. Enabling medication management through health information technology. Agency for Healthcare Research and Quality Technical Reviews 2011 Evidence R (11-E008-EF). 7 (Medium)
Qureshi N, Allen J, Hapgood R. A systematic review of educational outreach visits for non-prescribing interventions in general practice. European Journal of General Practice 2002 8 (1):31-6. 7 (Medium)
Smolders M, Laurant M, Roberge P, van Balkorn A, van Rijswijk E, Bower P, Grol R. Knowledge transfer and improvement of primary and ambulatory care for patients with anxiety. Canadian Journal of Psychiatry 2008 53 (5):277-93. 7 (Medium)
Thomas RE, Russell ML, Lorenzetti DL. Systematic review of interventions to increase influenza vaccination rates of those 60 years and older. Vaccine 2010 28 (7):1684-701. 7 (Medium)
Zwarenstein M, Goldman J, Reeves S. Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews 2009 3:CD000072. 7 (Medium)
Brusamento S, Legido-Quigley H, Panteli D, Turk E, Knai C, Saliba V, Car J, McKee M, Busse R. Assessing the effectiveness of strategies to implement clinical guidelines for the management of chronic diseases at primary care level in EU Member States: a systematic review. Health Policy 2012 107 (41700):169-183. 6
Summary Pending
Firmstone VR, Elley KM, Skrybant MT, Fry-Smith A, Bayliss S, Torgerson CJ. Systematic review of the effectiveness of continuing dental professional development on learning, behavior, or patient outcomes. Journal of Dental Education 2013 77 (3):300-315. 6
Summary Pending
Gilbody S, Whitty P, Grimshaw J, Thomas R. Educational and organizational interventions to improve the management of depression in primary care: a systematic review. JAMA 2003 289 (23):3145-51. 6 (Medium)
Williams N, Woodward H, Majeed A, Saxena S. Primary care strategies to improve childhood immunisation uptake in developed countries: systematic review. JRSM Short Reports 2011 2 (10):81, 2011. 6 (Medium)
Alvarez MP, Agra Y. Systematic review of educational interventions in palliative care for primary care physicians. Palliative Medicine 2006 20 (7):673-83. 5 (Medium)
Coory M, White VM, Johnson KS, Hill DJ, Jefford M, Harrison S, Winship I, Millar J, Giles GG. Systematic review of quality improvement interventions directed at cancer specialists. Journal of Clinical Oncology 2013 31 (12):1583-1591. 5
Summary Pending
Hakkennes S, Dodd K. Guideline implementation in allied health professions: a systematic review of the literature. Quality and Safety in Health Care 2008 17 (4):296-300. 5 (Medium)
Hulscher ME, Wensing M, van Der Weijden T, Grol R. Interventions to implement prevention in primary care. Cochrane Database of Systematic Reviews 2001 1:CD000362. 5 (Medium)
Lugtenberg M, Burgers J, Westert G. Effects of evidence-based clinical practice guidelines on quality of care: a systematic review. Quality and Safety in Health Care 2009 18 (5):385-92. 5 (Medium)
Ryman TK, Dietz V, Cairns KL. Too little but not too late: Results of a literature review to improve routine immunization programs in developing countries. BMC Health Services Research 2008 8:134. 5 (Medium)
Smith LA, Jones C, Meek S, Webster J. Review: Provider practice and user behavior interventions to improve prompt and effective treatment of malaria: do we know what works? American Journal of Tropical Medicine and Hygiene 2009 80 (3):326-35. 5 (Medium)
Steinman MA, Ranji SR, Shojania KG, Gonzales R. Improving antibiotic selection: a systematic review and quantitative analysis of quality improvement strategies. Medical Care 2006 44 (7):617-28. 5 (Medium)
Chaillet N, Dube E, Dugas M, Audibert F, Tourigny C, Fraser WD, Dumont A. Evidence-based strategies for implementing guidelines in obstetrics: a systematic review. Obstetrics and Gynecology 2006 108 (5):1234-45. 4 (Medium)
Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E, Morton SC, Shekelle PG. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Annals of Internal Medicine 2006 144 (10):742-52. 4 (Medium)
Coverdale JH, Balon R, Roberts LW. Teaching sexual history-taking: a systematic review of educational programs. Academic Medicine 2011 86 (12):1590-5. 4 (Medium)
Fish A, Watson MC, Bond CM. Practice-based pharmaceutical services: a systematic review. International Journal of Pharmacy Practice 2002 10 (4):225-33. 4 (Medium)
Howe A, Ashton K, Hooper L. Effectiveness of educational interventions in primary care mental health: A qualitative systematic review. Primary Care and Community Psychiatry 2006 11 (4):167-177. 4
Summary Pending
Lineker S, Husted J. Educational interventions for implementation of arthritis clinical practice guidelines in primary care: Effects on health professional behavior. Journal of Rheumatology 2010 37 (8):1562-9. 4 (Medium)
Loganathan M, Singh S, Franklin BD, Bottle A, Majeed A. Interventions to optimise prescribing in care homes: systematic review. Age and Ageing 2011 40 (2):150-162. 4 (Medium)
Mansell G, Shapley M, Jordan JL, Jordan K. Interventions to reduce primary care delay in cancer referral: a systematic review. British Journal of General Practice 2011 61 (593):e821-e835. 4 (Medium)
Nishtala PS, McLachlan A, Bell JS, Chen TF. Psychotropic prescribing in long-term care facilities: impact of medication reviews and educational interventions. American Journal of Geriatric Psychiatry 2008 16 (8):621-32. 4 (Medium)
Ostini R, Hegney D, Jackson C, Williamson M, Mackson JM, Gurman K, Hall W, Tett SE. Systematic review of interventions to improve prescribing. Annals of Pharmacotherapy 2009 43 (3):502-13. 4 (Medium)
Smits PB, Verbeek JH, de Buisonje CD. Problem based learning in continuing medical education: a review of controlled evaluation studies. BMJ 2002 324 (7330):153-6. 4 (Medium)
Wensing M, Grol R. Single and combined strategies for implementing changes in primary care: a literature review. International Journal for Quality in Health Care 1994 6 (2):115-32. 4 (Medium)
Chhina HK, Bhole VM, Goldsmith C, Hall W, Kaczorowski J, Lacaille D. Effectiveness of academic detailing to optimize medication prescribing behaviour of family physicians. Journal of Pharmacy & Pharmaceutical Sciences 2013 16 (4):511-529. Summary Pending
Kamarudin G, Penm J, Chaar B, Moles R. Educational interventions to improve prescribing competency: a systematic review. Bmj open 2013 3 (8):e003291. Summary Pending
Tjia J, Velten SJ, Parsons C, Valluri S, Briesacher BA. Studies to reduce unnecessary medication use in frail older adults: a systematic review. Drugs & Aging 2013 30 (5):285-307. Summary Pending