摘要：Aim: To assess and to compare the effectiveness of two accompanying measures for general practitioners carried out by medical advisers of the general scheme on prescriptions for sick leave as regards health risks, occupational health and safety.Methods: A randomised prospective study in three parallel groups over three health fund districts. After selection on the basis of their prescription profile, general practitioners were divided up into a control group, a group which received a personalised letter and a group which received a personalised letter and was followed up by individual academic detailing. Accompaniment took place from May to September 2004 and the analysis covered a comparison of sick leaves prescribed by each of the groups during the last quarter of 2004, rounded off by a chronological series showing the prescription profiles of each group.Results: Accompaniment by academic detailing did not prove to be more effective than personalised letters. On average, each physician from both these groups prescribed one day’s sick leave less per analysed day than physicians in the control group: for the letter group p = 0.04 inter-scheme and p = 0.049 for the general scheme and for the group in which interviews were conducted among colleagues, p < 0.05 inter-scheme and p = 0.05 for the general scheme.Conclusion: Academic detailing did not add any value to a personalised letter as regards prescriptions for sick leave. Explanations are multiple, but the predominance of extra-medical causes in prescriptions for sick leave seems to be one of the more plausible reasons.
