Effect of an Educational Outreach Program on Prescribing Potential Drug-Drug Interactions

BACKGROUND: The topic of improving prescribing practices is a major focus of many national initiatives, not only to enhance the quality of health care but also to reduce medical care costs. Educational outreach (also known as academic detailing) is a type of postgraduate education where trained clinical consultants meet face-to-face with prescribers to provide one-on-one information. Ideally, such visits promote evidence-based knowledge, create trusting relationships, and induce practice change, particularly with regard to prescribing potentially interacting medications. OBJECTIVES: To evaluate the effect of an educational outreach program delivered by clinical pharmacists on reducing the rate of prescribing potential drug-drug interactions (DDIs). METHODS: The intervention was a prescriber-directed educational outreach program focused on 25 clinically important DDIs. The effect of the educational outreach was evaluated using a retrospective pre-post study design with a control group was conducted. A total of 19,606 prescribers were educated on the DDIs of interest. A control group of 19,606 prescribers, matched on prescribing volume and who did not receive the educational session were selected. Multivariate regression models were used to assess the impact of the educational program on the rate of prescribing potential DDIs. RESULTS: The 2 groups were significantly different with respect to age, profession, specialty, and geographic region. At baseline, mean DDI rates per 100 drug prescriptions were 0.8 and 0.7 for prescribers who received the educational session and those who did not, respectively. Following delivery of the educational outreach program, mean potential DDI rates increased to 1.46 and 1.53 per 100 precipitant drug prescriptions, an increase of 13.9% and 9.15% for the intervention and control groups, respectively. CONCLUSIONS: The current study was not able to demonstrate a significant beneficial effect of the educational outreach program on reducing the rate of prescribing potential DDIs.