A New Approach to Reducing Suboptimal Drug Use

From JAMA

By Jerry Avorn, MD; Stephen B. Soumerai, MSPH

SUMMARY: This 1983 JAMA letter/brief report by Avorn and Soumerai serves as a companion to their landmark NEJM randomized controlled trial published the same year, introducing their approach to reducing suboptimal drug use through educational outreach to physicians. Together, the two 1983 papers established the conceptual and empirical foundation for academic detailing as a field. The JAMA piece reaches the clinical readership of the world's most widely circulated medical journal with the core argument: that physician prescribing behavior can be improved through structured, evidence-based educational outreach, and that this model represents a viable alternative to the pharmaceutical industry's promotional detailing as the primary channel through which drug information reaches clinicians. (Note: Full text paywalled; summary based on publicly available DOI, title, authors, and companion NEJM paper context.)

BACKGROUND: Suboptimal drug use — including overuse of drugs with poor benefit-risk profiles — was identified as a significant clinical and public health problem in the early 1980s, with no evidence-based educational intervention proven to address it.

KEY FINDINGS: Educational outreach to physicians offers a new approach to reducing suboptimal drug use, as demonstrated by the companion 1983 NEJM randomized controlled trial.

IMPLICATIONS: Academic detailing provides a replicable, evidence-based model for improving drug therapy decisions that reaches physicians in their own practice settings, complementing policy and regulatory approaches to medication quality improvement.