Academic detailing program for rheumatoid arthritis: a contribution to Brazilian public health system sustainability

Objectives In Brazil, specialty medicines for rheumatoid arthritis (RA) treatment are provided by the national health system (NHS) according to mandatory protocols. Knowing the rules for prescription of these biological agents is crucial to ensuring patient access to treatment. This study aims to evaluate the feasibility of an academic detailing strategy to promote the quality use of the medicines available in NHS among prescribers. Methods Forty-three specialists and general practitioners were visited by researchers to perform an academic detailing of the Clinical Protocols and Therapeutic Guidelines (PCDT) for RA adopted by NHS. After the visits, a survey was performed with prescribers to measure their perception in terms of satisfaction and information reliability with the academic visits. At the end, we perform a cost analysis to permit comparisons of this strategy with other educational activities. Key findings From 43 physicians that were visited, 28 responded to the telephone survey. Of these, 68% were very satisfied with the visit, 50% rated the content of the visit relevant to their practice, 64.3% agreed the duration of the visit did not affect their work, 60.7% agreed the distributed material would be useful for their professional practice, and 57.1% agreed that the visits added to their knowledge. A total of USDPPP 162.96 per prescriber (USDPPP 7,007.20, BRL14,185.00) were spent on the program. Conclusion The prescribers visited represent a large number of deferrals for the Specialized Component of Pharmaceutical Care (CEAF) drug applications. Therefore, the total amount spent on the implementation of this program and its potential for improving access to these medicines has the possibility to have a positive impact on the targeting of public expenditures and avoiding litigation against NHS. Academic detailing has the capability to become an effective strategy for PCDT dissemination and implementation.