404 Hong Kong Med J Vol 15 No 5 # October 2009 # www.hkmj.org Academic detailing at KIST Medical College, Lalitpur, Nepal: initial experiences LETTER TO THE EDITOR Academic detailing (AD) has been defined as a form of continuing medical education in which a trained health professional (physician or pharmacist) visits physicians in their offices to provide evidence-based information about medicines and therapeutics. 1 Academic detailing is common in developed countries. In Nepal however, it is not at all common, so a pilot study to determine the impact of AD on knowledge, attitudes, and practice towards diarrhoea management in children is now underway. 2 KIST Medical College is a new medical school in Lalitpur district, Nepal, where the Department of Clinical Pharmacology has carried out many interventions to promote the rational use of medicines. 3 Sessions entailing AD have been conducted for the last one year using a large group format. Each session was held in the hospital lecture hall every alternate Tuesday afternoon, and around 25 doctors, dentists, medical and dental officers participated. The first session was held in mid-June 2008. Detailing focused on drugs available in the Nepalese market or which were to be introduced there shortly. Occasionally, recent advances in therapy of particular diseases were covered. The focus was usually on single drugs or drug combinations, but occasionally a therapeutic class was also discussed. Oral rehydration salts, paracetamol, serratiopeptidase preparations, fixed dose combinations of ampicillin/amoxicillin and cloxacillin, and ibuprofen and paracetamol, coamoxiclav have been detailed. Newer uses for older drugs were also covered with the respective levels of evidence for such use. Recent advances in therapy of asthma, type 1 and type 2 diabetes mellitus, interpretation of clinical trials and common References 1. Kondro W. Academic drug detailing: an evidence-based alternative. CMAJ 2007;176:429-31. 2. Khanal S, Palaian S, Shankar PR, Mishra P, Ibrahim MI. Let us try academic detailing as a tool to reduce global mortality from childhood diarrhoea by 2015. PLOS Medicine website: http://www.plosmedicine.org/annotation/listThread.action?inReplyTo =info%3Adoi%2F10.1371%2Fannotation%2Fb1c013c0-fb3d-46f5-bb81-55af4b99d7ad&root=info%3Adoi%2F10.1371%2F annotation%2Fb1c013c0-fb3d-46f5-bb81-55af4b99d7ad. Accessed 14 Jun 2009. 3. Shankar PR, Jha N, Shrestha RK, et al. Promoting the more rational use of medicines: initial experiences from KIST Medical College, Lalitpur, Nepal. Journal of Medicine Use in Developing Countries 2009;1:3-15. dosage forms and their significance to prescribers have also been addressed. Antibiotic resistance and the urgent need for action to deal with this problem was debated. An antimicrobial management team has been constituted and an antibiotic use protocol developed. Informal feedback obtained from the participants has been positive. The sessions and the Medicine Information Services have been well received and accepted as a source of unbiased, objective information. The audience is diverse and certain sessions may not be of interest to ‘specialists’. Keeping in mind the limited resources and other demands on the department, it has not been possible to conduct sessions for individual departments. With increasing patient loads and the expansion of services, the frequency of detailing has decreased to once in 3 weeks. In the near future, we plan to obtain feedback using a questionnaire. The feasibility of small group detailing for certain departments is being explored. Sessions entailing AD can be conducted in developing countries. The department plans to continue and develop this educational tool in the coming years. PR Shankar, MD E-mail: ravi.dr.shankar@gmail.com N Jha, MPharm RK Shrestha, MPharm O Bajracharya, MPharm HS Thapa, MPharm KIST Medical College PO Box 14142 Kathmandu, Nepal