Academic detailing on bDMARD prescribing offered to dermatologists


Professor Debra Rowett

Dermatologists are being offered 30-minute educational visits from NPS MedicineWise as part of the Value in Prescribing bDMARDs program for conditions such as plaque psoriasis.

The initiative, which also covers use of bDMARDs in gastroenterology and rheumatology, builds on 20 years of similar visits to GPs around the country to promote the quality use of medicines.

Professor Debra Rowett, Discipline Leader in Pharmacy: External Relations at the University of South Australia, told the limbic the GPs who have participated in the visits have found them valuable.

And while the focus of the visits to specialists may be slightly different, she expects many will find them a valuable addition into the mix of professional development opportunities.

She said preparation for the educational visits is done collaboratively – gathering, synthesising and critically appraising the best available evidence, and then having discussions with an advisory group to decide the core information taken out to the specialists.

 

“No matter how well you have done a meta-analysis or a systematic review, there is always judgment in weighing that evidence so it’s good to have those conversations with the experts and the specialists.”

According to Professor Rowett, there is no element of targeting particular practitioners or bDMARD prescribing patterns and visits are alway personalised to what the specialist wants to discuss.

“It is offered as a service. It’s a choice if they want to participate in it. We’re not coming to tell them about their specialty because they are the specialists.”

“And some of the specialists are the people doing the research and leading in their areas, so the discussion might be more about some of the additional resources that are available,” she said.

“Sometimes they might want to know about some of the other emerging evidence in the areas of their patients’ comorbidities and how their treatment might impact on those areas of practice.”

Professor Rowett said contemporary issues might include discussion about the use of biologics in the context of COVID-19 vaccines.

“The conversations can be quite diverse in that sense … obviously we won’t know everything …and so we might go back to do some more research, maybe speak with other specialists, get some other information together and be able to follow up and provide that after the visit.”

She said the visits embrace the principles of academic detailing and take the educational visit to the clinicians in hospital and private practice settings and at a time that suits them.

“It’s usually delivered in person although the pandemic has meant more have been done virtually….and we’re trying to make them as interactive as possible.”

She said there were changing patterns of use of medicines reflecting the emerging evidence and the opportunities that some of the new medicines provide in treating conditions where there might not have been other alternatives.

“At the end of the day, when they have been prescribed, we need to be supporting patients to use them well and help them … get a good outcome.”

“That might mean people stay on their treatment longer so there might be increased persistence on therapy, we might see less adverse effects that might arise from using the medicines well, and there might be less switching to another medicine.”

She said gastroenterology and rheumatology visits were already underway and dermatology visits are about to commence.

Specialists will receive information and invitations to participate directly or can register online for an educational visit.

Patient resources including decision aids and action plans are available to enhance discussion with patients.

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