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Pharmaceuticals from development to practice: learnings from an online curriculum.

OBJECTIVE
To report outcomes of a pilot online curriculum educating clinicians about off-label prescribing, finding unbiased sources of pharmaceutical information, and responding to patient inquiries about direct-to-consumer advertised medications.


STUDY DESIGN
Case study.


METHODS
We developed 3 case-oriented Internet modules to educate healthcare professionals about off-label prescribing, accessing and appraising unbiased drug information, and talking with patients about direct-to-consumer advertising. Modules included reflective questions and opportunities to asynchronously ask questions of faculty. Pilot testing occurred among 52 Kaiser Permanente Colorado prescribing clinicians from May 2007 through September 2007. We assessed self-reported changes in knowledge, intent-to-change practice, and barriers to practice change. We also examined curriculum participant pre-post changes in prescribing of selected highly advertised medications.


RESULTS
Most participants reported changes in knowledge after curriculum completion, many made intent-to-change practice statements at curriculum completion, and several reported changes in practice 3 to 6 months after curriculum completion. Six categories of barriers to practice change were noted. Prescribing of targeted medications rose by 0.8 prescription per month in the intervention group and by 6.3 prescriptions per month in the control group, but this difference was not significant (P = .17).


CONCLUSIONS
Targeted curricula on aspects of the pharmaceutical development, approval, and marketing process can lead to subjective changes in clinician knowledge and can facilitate intent-to-change practice. Larger studies are needed to assess the effect of such interventions on prescribing patterns.