Impact du visiteur médical indépendant sur la pratique des médecins de première ligne
Authors: Borgermans Liesbeth , Dubois Cécile , Rieppi Stéphane , Vanhaeren Stéphanie , Geukens Nick , Fallon Catherine , Claisse Frédéric , Massart Clémence , Brunet Sébastien , Kohn Laurence , Piérart Julien , Paulus Dominique 
Published: January 2025

Scientific summary -- Table of contents -- 1 BACKGROUND . 3 -- 1.1 ACADEMIC DETAILING . 3 -- 1.2 DEFINITIONS . 3 -- 1.3 ACADEMIC DETAILING IN BELGIUM . 4 -- 1.4 OBJECTIVE OF THE PROJECT . 4 -- 2 LITERATURE REVIEW ON ACADEMIC DETAILING . 5 -- 2.1 AIM OF THE LITERATURE REVIEW . 5 -- 2.2 METHODOLOGY . 5 -- 2.2.1 Population  Intervention - Comparison  Outcomes (PICO) . 5 -- 2.2.2 Search strategies . 5 -- 2.3 RESULTS . 8 -- 2.3.1 Systematic literature review . 8 -- 2.3.2 Academic Detailing programmes in other countries . 23 -- 2.4 DISCUSSION: RESULTS FROM THE INDEXED AND GREY LITERATURE . 33 -- 2.4.1 Widespread use of academic detailing . 33 -- 2.4.2 Rationale of academic detailing . 33 -- 2.4.3 The concept and content of academic detailing . 33 -- 2.4.4 Target population of caregivers . 34 -- 2.4.5 Professionals who provide academic detailing . 34 -- 2.4.6 Behaviour targeted by academic detailing programs . 34 -- 2.4.7 Conditions and diseases targeted by academic detailing programmes . 35 -- 2.4.8 Patients targeted by AD programmes: specific populations. 35 -- 2.4.9 Effectiveness of academic detailing on clinical outcomes . 35 -- 2.4.10 Cost-effectiveness of academic detailing . 36 -- 2.4.11 Effectiveness of AD programmes compared to other interventions . 36 -- 3 QUALITATIVE STUDY AMONG GENERAL PRACTITIONERS . 38 -- 3.1 OBJECTIVE OF THIS PART . 38 -- 3.2 METHODOLOGY . 38 -- 3.2.1 Tools for data collection: interviews and Mesydel methods . 38 -- 3.2.2 Methodological background: Grounded Theory . 39 -- 3.2.3 Population . 40 -- 3.2.4 Protocols . 41 -- 3.2.5 Sampling . 42 -- 3.2.6 Development of the Mesydel questions . 43 -- 3.2.7 Summary of the methodology . 43 -- 3.3 ANALYSIS . 44 -- 3.3.1 The GPs and their context . 44 -- 3.3.2 Perception of the Farmaka visit and visitor by the GPs . 49 -- 3.3.3 Impact of the Farmaka visit: what works . 51 -- 3.3.4 Impact of the Farmaka visit: what does not work . 53 -- 3.3.5 Wishes of interviewed GPs . 54 -- 3.4 CRITICAL DISCUSSION OF RESULTS AND ENHANCEMENT LINES . 57 -- 3.4.1 Biases . 57 -- 3.4.2 Discussion of some seemingly contradictory opinions in the analysis . 58 -- 3.4.3 Further research . 59 -- 3.5 IMPROVEMENT PATHS: SUGGESTIONS FOR IMPLEMENTATION . 60 -- 3.5.1 EBM for specialist physicians . 60 -- 3.5.2 Support of the medical information . 60 -- 3.5.3 Online forum and focus groups for GPs . 60 -- 3.5.4 Emerging problem: patients who misuse the Internet for self-diagnosis . 61 -- 3.5.5 Farmakas visitor profile . 61 -- 3.5.6 Choice of the topic of the visit by the GP . 61 -- 3.5.7 Better target group for the AD visits . 61 -- 3.5.8 Accreditation procedure linked to the Farmaka visit . 62 -- 3.5.9 Enhancing awareness of Farmaka amongst GPs . 62 -- 3.5.10 Life-long learning . 62 -- 4 PRESCRIPTION DATA OF A SELECTED SAMPLE OF BELGIAN GPS . 63 -- 4.1 BACKGROUND . 63 -- 4.1.1 Choice of the topics . 63 -- 4.1.2 Key messages of Farmaka AD visitors . 63 -- 4.2 METHODOLOGY . 64 -- 4.2.1 Data source . 64 -- 4.2.2 Planned Analyses . 64 -- 4.2.3 Statistics . 65 -- 4.2.4 Rules . 65 -- 4.3 RESULTS . 67 -- 4.3.1 Diabetes . 67 -- 4.3.2 Dementia . 83 -- 4.4 DISCUSSION: ANALYSIS OF THE GPS PRESCRIPTIONS . 88 -- 5 CONCLUSIONS . 90 -- 5.1 LITERATURE FINDINGS: MODERATE EFFECTIVENESS ON THE PRACTICE. 90 -- 5.2 EFFECTIVENESS NOT DEMONSTRATED IN THIS STUDY . 90 -- 5.3 ACADEMIC DETAILING IN BELGIUM: WHICH WAY FORWARD? . 91 -- 5.3.1 Choice of topic . 91 -- 5.3.2 Target population of physicians . 91 -- 5.3.3 Face-to-face or . ? . 91 -- 5.3.4 Background of the visitor . 92 -- 5.3.5 Other suggestions from GPs in Belgium . 92 -- 6 REFERENCES . 93