This 2002 research study explored the effectiveness of academic detailing on physician knowledge and practices related to preventative care for women exposed to synthetic estrogen (DES).
Physician participants were visited by a trained physician and received educational materials, management guidelines, chart reminders, medical history forms, office posters and brochures. They were informed about the reasons of why it was important to take a DES history. A lecture was featured to introduce the goals of this educational program to the participants. Physicians took a pre-intervention and post-intervention test that evaluated the change in their knowledge. To help assess study outcomes, patients likewise engaged in pre-intervention and post intervention surveys. While the study relied on self-reported outcome measures, the results revealed that academic detailing may increase physician knowledge and history taking practice.
Diethylstilbestrol (DES), a synthetic estrogen prescribed during pregnancy between 1938 and 1971, was later shown to have serious health effects, including higher risks of cancer in daughters and mothers. The authors report results of an intervention to increase health care providers’ awareness of preventive care for women exposed to DES before birth.
A controlled trial enrolled 20 to 25 health care providers in each of three communities to test the effectiveness of an academic detailing intervention. Outcomes (knowledge, routine screening) were assessed by provider questionnaires and patient surveys.
DES knowledge, familiarity with national guidelines, and screening for exposure increased significantly in the intervention communities but not in the control communities. The intervention effect for DES screening was significant (p = 0.01). Patient surveys confirmed provider self-report.
Academic detailing can increase DES knowledge and history taking among primary care providers. This intervention could be disseminated to increase knowledge of DES preventive care.
Sources and more information
- The National DES Education Program: Effectiveness of the California Health Provider Intervention, American Board of Medical Specialties, 04/2002.
- The National DES Education Program: effectiveness of the California Health Provider Intervention, Journal of cancer education: the official journal of the American Association for Cancer Education, NCBI PMID:12000106, 2002 Spring.
- NATIONAL DES EDUCATIONAL PROGRAM FOR HEALTH PROFESSIONALS AND THE PUBLIC, NIH Guide, Volume 22, Number 15, April 16, 1993.
More DES DiEthylStilbestrol Resources
- DES studies on cancers and screening.
- DES studies on epigenetics and transgenerational effects.
- DES studies on fertility and pregnancy.
- DES studies on gender identity and psychological health.
- DES studies on in-utero exposure to DES and side-effects.
- DES studies on the genital tract.
- Papers on DES lawsuits.
- DES videos and posts tagged DES, the DES-exposed, DES victims.