Research Article Open Access Quality in Primary Care (2017) 25 (2): 63-72 Research Arcle 2017 Insight Medical Publishing Group Qualitative Insights into Family Physicians' Perceptions of Academic Detailing for Rheumatoid Arthritis Harpreet Chhina Arthris Research Center of Canada, Richmond, BC, University of Brish Columbia, Canada Wendy Hall School of Nursing, University of Brish Columbia, Canada Janusz Kaczorowski Department of Family and Emergency Medicine, Université de Montréal and CRCHUM, Canada Carlo Marra School of Pharmacy, Otago University, New Zealand Diane Lacaille Division of Rheumatology, Faculty of Medicine, University of Brish Columbia, Canada Purpose: The message of a paradigm shift in the treatment of rheumatoid arthritis (RA) to early, aggressive and sustained use of Disease Modifying Anti-Rheumatic Drugs and treating to target remission, has not yet reached all Family Physicians (FPs) in Canada. A promising technique to optimize FP practice is Academic Detailing (AD) which involves visits by trained health care professionals to physicians in their offices, providing evidence-based information on a selected topic. The objective of our study was to understand FPs’ perceptions about the feasibility, acceptability, and utility of AD to provide information about RA management. Methods: We conducted one-on-one semi-structured telephone interviews with twelve consecutive FPs who participated in an AD intervention for RA and who agreed to be interviewed. Interview transcripts were analyzed using a qualitative descriptive approach with inductive content analysis. Results: FPs reported appreciating AD for its educational value, convenience, one-on-one interaction, short duration; subject expert input in content, and practical, evidence-based and focused content. Some FPs identified disadvantages, such as difficulty incorporating AD during work days, lack of dedicated CME time, insufficient time for detailed discussions, lack of time to consult information left behind and standardization of the message delivered. AD was acceptable to most FPs, who reported perceived benefits of the visits, including improved confidence in managing RA, anticipating clinical practice changes and willingness to receive AD in the future. Conclusion: Participating FPs perceived AD as a feasible, acceptable and useful CME technique to receive information about RA management aimed at optimizing care. Keywords: Academic detailing; Rheumatoid arthritis; Family physicians; Interviews; DMARDS ABSTRACT Introducon There has been a paradigm shift in the approach to Rheumatoid arthritis (RA) treatment, with current guidelines recommending early, aggressive and consistent use of disease- modifying anti-rheumatic drugs (DMARDs), with remission as the new target [1-6]. The delivery of care for RA has been shown to be suboptimal [7-14]. In British Columbia (BC), we found low rates of DMARD use and referral to rheumatologists [15]. Similar findings were observed in Quebec, Ontario and United States [8,10,16]. Other researchers have found long delays in receiving care [12,17]. This highlights the importance of addressing the gaps in RA care by informing family physicians (FPs) about recent changes in RA management. Previous studies revealed that many FPs lacked confidence to undertake early diagnoses of RA, and prescription of DMARDs, as well as the need for a shift in approaching RA care [15,18]. Changing physician’s well-established clinical practice patterns can be difficult [19]. Continuing Medical Education (CME) has accounted for one third of clinical practice changes of FPs and consultants [20]. Studies have shown that techniques, such as academic detailing (AD), audit/feedback, and reminders, are more effective than dissemination of guidelines through traditional channels [21-26]. AD is a form of CME where trained health care professionals, such as pharmacists or physicians, visit physicians in their offices to provide unbiased, evidence-based information on a selected topic [27]. AD has been shown to be effective at optimizing clinical practice behaviours [27-32] and has improved care in chronic diseases [33-39]. To date we are aware of only one