Randomised trial of intensive academic detailing to promote opportunistic recruitment of women to cervical screening by general practitioners

https://doi.org/10.1111/j.1467-842X.2003.tb00394.xGet rights and content
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Abstract

Objective

To evaluate a multifaceted intervention involving intensive academic detailing for general practitioners (GPs) to improve recruitment of women for cervical screening.

Methods

We conducted a cluster randomisation trial involving 39 general practices in inner‐metropolitan Sydney. GPs' knowledge, propensity to an opportunistic approach, competence and confidence were assessed by self‐report before and after the intervention. To measure GP behaviour, recall of an opportunistic discussion about cervical screening was determined in cross‐sectional samples of female patients at baseline (n = 1,090) and post‐test (n = 1,062).

Results

Knowledge improved marginally in both groups but there were no changes in other GP self‐reported measures. At post‐test, women attending GPs in the intervention group were no more likely than those in the control group to recall an opportunistic inquiry about their cervical screening status (OR 0.65, 95% CI 0.40–1.08). Women in the intervention group who were overdue for cervical screening were no more likely than their control group counterparts at post‐test to recall advice about cervical screening (OR 2.16, 95% CI 0.75–6.14) or written information (OR 0.34, 95% CI 0.04–26.5).

Conclusions

Intensive academic detailing does not improve an opportunistic approach to cervical screening in general practice.

Implications for public health practice

In an evidence‐based climate, implementation of academic detailing as a strategy to improve cervical screening rates in general practice would be premature.

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