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Appendix

Appendix Delphi Exercise Round 1 Survey

[Note: This Appendix to “Key Features of Academic Detailing: Development of an Expert Consensus Using the Delphi Method” by Dr Yeh and colleagues provides supplemental material to the article; it is posted in its original format with no editorial changes]

 

Ordinal rating scale:
1—Not at all important
2—Somewhat important
3—Very important
4—Essential

Week 1 Survey

Section 1: Content

1. We would like to identify the importance of different elements of academic detailing.
Our recent systematic review identified the following components of academic detailing interventions. The total percentage exceeds 100 as most studies included multiple components.

Clinician education (87%)
Feedback about clinical performance (72%)
Recommendations about practice changes (63%)
Clinician reminders (53%)
Practice facilitation (eg, implementation of disease registry) (33%)
Patient education (31%)
Opinion leaders (18%)
Patient reminders (12%)
Technical and other assistance (eg, IT support) (12%)
Patient resources (eg, diaries, medication lists, contracts for care) (11%)
Community resources (eg, transportation, pharmacies, radiology facilities) (11%)
Documentation tools for clinicians (8%)
Commitment to change (8%)
Care coordination or case management (8%)
Continuing education guidance (eg, learning style assessment and strategies) (6%)
Decision support (6%)
Sharing best practices (5%)
Patient care equipment (5%)
Financial and other incentives (5%)
Social marketing (2%)

 

With this information in mind but not limited by it, please indicate how important you believe each component is to academic detailing interventions.
Scale: 1 not at all important, 2 somewhat important, 3 very important, 4 essential

□ Clinician education
□ Feedback about clinical performance
□ Recommendations about practice changes
□ Clinician reminders
□ Practice facilitation (eg, implementation of disease registry)
□ Patient education
□ Opinion leaders
□ Patient reminders
□ Technical and other assistance (eg, IT support)
□ Patient resources (eg, diaries, medication lists, contracts for care)
□ Community resources (eg, transportation, pharmacies, radiology facilities)
□ Documentation tools for clinicians
□ Commitment to change
□ Care coordination or case management
□ Continuing education guidance (eg, learning style assessment and strategies)
□ Decision support
□ Sharing best practices
□ Patient care equipment (eg, blood pressure device)
□ Financial and other incentives
□ Social marketing

Comments: __________________________________________________________________

 

2. Prior studies of academic detailing evaluated the following outcomes. The total percentage exceeds 100 as many studies evaluated more than one outcome.

Clinician behavior or performance (92%)
Patient outcomes (43%)
Clinician knowledge or awareness (7%)
Clinician skill (<1%)
Other (collectively 12%)
  Care intensity
Changes in educational activities
Changes in workflow
Clinician attitude
Cost
Family satisfaction
Prevalence of condition or disease
Resource utilization

With this information in mind but not limited by it, please indicate the importance of each of these outcomes in evaluating academic detailing.
Scale: 1 not at all important, 2 somewhat important, 3 very important, 4 essential

□ Clinician behavior or performance
□ Patient outcomes
□ Clinician knowledge or awareness
□ Clinician skill
□ Care intensity
□ Changes in educational activities
□ Changes in workflow
□ Clinician attitude
□ Cost
□ Family satisfaction
□ Prevalence of condition or disease
□ Resource utilization

Comments: __________________________________________________________________

 

Our systematic review identified whether and how studies tailored information as part of academic detailing visits:

Information without tailoring (14%)
Information with tailoring (86%)

If tailored, the following were ways that tailoring occurred:
Specific feedback about performance
Ad hoc visits, resources, and support upon request
Discussion, barriers and solutions
Discussion, challenging cases
Discussion, context
Discussion, feasibility
Discussion, general and progress
Discussion, quality improvement approach, strategies, and interventions
Meetings with peers and specialists facilitated
Model of discussion or teaching technique (eg, teach back)
Ongoing needs assessment
Role playing

3a. With this information in mind but not limited by it, should information delivered in academic detailing visits be tailored to the individual?

□ No (Skip to question 4)
□ Yes (continue with 3b)

Comments: __________________________________________________________________

3b. If yes, please indicate the importance of each of these elements of information in academic tailoring intervention:
Scale: 1 not at all important, 2 somewhat important, 3 very important, 4 essential

□ Specific feedback about performance
□ Ad hoc visits, resources, and support upon request
□ Discussion, barriers and solutions
□ Discussion, challenging cases
□ Discussion, context
□ Discussion, feasibility
□ Discussion, general and progress
□ Discussion, quality improvement approach, strategies, and interventions
□ Meetings with peers and specialists facilitated
□ Model of discussion or teaching technique (eg, teach back)
□ Ongoing needs assessment
□ Role playing

Comments: __________________________________________________________________

 

Section 2: Clinicians

4. Prior studies used the following reasons to select providers for academic detailing visits (percentage exceeds 100 as more than one reason per study may apply):

Geographical area or particular organization (99%)
Specialty or specific setting (84%)
Patient population (17%)
Pattern of care (5%)

4. With this information in mind but not limited by it, please indicate the importance of the following factors in selecting providers for academic detailing? Please select all that apply.
Scale: 1 not at all important, 2 somewhat important, 3 very important, 4 essential

□ Geographical area or particular organization
□ Specialty or specific setting
□ Patient population
□ Pattern of care

Comments: __________________________________________________________________

 

Section 3: Communication Process

5. Systematic review of the literature identified the following information about academic detailing visits in published articles:

Statistic

Number of visits per provider

Frequency of visits (months)

Duration of visits (minutes)

Time between first and last visit (months)

Mean

2.8

3.5

90

7.4

Median

2

3

60

6

Mode

1

6

60

6

Range

1-50

daily to 7 months

7 minutes to
2 days

0.5-18

5. With this information in mind but not limited by it, please indicate the importance of the following facets of visits to academic detailing?
Scale: 1 not at all important, 2 somewhat important, 3 very important, 4 essential

□ Number of visits
□ Frequency of visits
□ Duration of each visit
□ Duration of entire visit period (time between first and last visit)

Comments: __________________________________________________________________

6. Prior academic detailing interventions focused of the following professional roles (percentage exceeds 100 as more than one position per study may apply):

Clinicians (99%)
Non-clinical staff (20%)
Other (collectively 10%)
  Administrator
External party
Patients
Unspecified internal party

With this information in mind but not limited by it, please indicate the importance of the following groups in academic detailing.
Scale: 1 not at all important, 2 somewhat important, 3 very important, 4 essential

□ Clinicians
□ Non-clinical staff
□ Administrators
□ Patients

Comments: __________________________________________________________________

 

Section 4: Academic Detailing Outreach Workers

7. The training or qualifications of academic detailers have included (percentage exceeds 100 as more than one qualification per study may apply):

Physician (40%)
Pharmacist (34%)
Nurse (27%)
Team approach (10%)
Public health practitioner (2%)
Other (collectively 30%)
  Administrator
Clinical or health educator
Faculty member, unspecified
Other background, skills, or experience
Other clinical discipline or science background
Quality improvement expert
Pharmaceutical industry representative
Research team member or leader

7. With this information in mind but not limited to it, please indicate the importance of the following qualifications for academic detailers.
Scale: 1 not at all important, 2 somewhat important, 3 very important, 4 essential

□ Physician
□ Pharmacist
□ Nurse
□ Team approach
□ Public health practitioner
□ Clinical or health educator
□ Quality improvement expert
□ Pharmaceutical industry representative

Comments: __________________________________________________________________

8. In 45% of prior studies, academic detailers had special training for their outreach visits, including training in one or more of the following areas:

Academic detailing or educational outreach
Anticipated barriers
Behavior change and persuasion
Communication and interpersonal skills
Content of study (eg, guidelines and evidence)
Debriefings on visits
Education (eg, making presentations and facilitating discussion)
Networking
Quality improvement
Rehearsals and role playing
Resources and interventions being offered
Social marketing
Supervised observations (receipt of, with feedback)

8. With this information in mind but limited by it, please indicate the importance of training for academic detailers in the following areas.
Scale: 1 not at all important, 2 somewhat important, 3 very important, 4 essential

□ Academic detailing or educational outreach
□ Anticipated barriers
□ Behavior change or persuasion
□ Communication and interpersonal skills
□ Content of study (eg, guidelines and evidence)
□ Debriefings on visits
□ Education (eg, making presentations and facilitating discussion)
□ Networking
□ Quality improvement
□ Rehearsals and role playing
□ Resources and interventions being offered
□ Social marketing
□ Supervised observations (receipt of, with feedback)

Comments: __________________________________________________________________

9. In 36% of studies documentation about the employer of the academic detailer was provided, with 30 studies (29%) noting that worker had a different (or external) employer than the providers being visited and 8 studies (8%) noting that the worker shared the same employer as the providers.

9. With this information in mind but not limited by it, should the academic detailing outreach worker necessarily have the same or a different employer than the providers being visited? Please select the item that better describes your expert opinion.

□ Different employer
□ Same employer

Comments: __________________________________________________________________

Last modified: August 30, 2021