Understanding State-Level Variations in Implementing Academic Detailing for Prescribing Opioids: Findings from 11 States Within the United States

Author:

Underwood Natasha L1ORCID,Cance Jessica Duncan2,Kane Heather2,Hennessy Caitlin2,Christensen Aleta1,Rooks-Peck Cherie1

Affiliation:

1. Division of Overdose Prevention, National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention , Atlanta, Georgia, USA

2. RTI International, Research Triangle Park , North Carolina, USA

Abstract

Abstract Objective Academic detailing is a clinical education technique characterized by targeted, one-on-one, interactive conversations between trained staff and the clinician. This study describes variations in implementing academic detailing among jurisdictions receiving funding from the U.S. Centers for Disease Control and Prevention (CDC) to prevent prescription drug overdoses. Design In 2015, CDC started the Prescription Drug Overdose Prevention for States (PfS) program. Subjects This study focuses on 11 of the 29 funded jurisdictions that implemented academic detailing as part of their PfS efforts. Methods Jurisdictions provided annual progress reports from 2016 to 2019. We conducted semistructured interviews in 2017 and 2018 with all funded jurisdictions and conducted follow-up interviews with three jurisdictions in 2020 to obtain additional context. We used an analytic matrix display to identify themes from annual progress report data, the coding report from the 2017/2018 interviews, and the three follow-up interviews from 2020. Results Two academic detailing models emerged: 1) one-on-one detailing, where centrally trained staff conducted all visits, and 2) a train-the-trainer model. Jurisdictions also described a hybrid model, which they referred to as academic detailing despite not meeting the definition of academic detailing. We identified variations in delivery strategies, staffing, and curriculum development within and between models. Despite these differences, common themes included the need to use data to focus academic detailing and the importance of partnerships. Conclusions Adoption of academic detailing as a strategy for improving opioid prescribing behaviors has increased. However, there is limited guidance and standardization to guide and evaluate implementation and outcomes.

Funder

Evaluation of the Prescription Drug Overdose Prevention for States Program

U.S. Centers for Disease Control and Prevention

Publisher

Oxford University Press (OUP)

Subject

Anesthesiology and Pain Medicine,Neurology (clinical),General Medicine

Reference39 articles.

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2. Trends and geographic patterns in drug and synthetic opioid overdose deaths—United States, 2013–2019;Mattson;Morb Mort Weekly Rep,2021

3. CDC guideline for prescribing opioids for chronic pain—United States, 2016;Dowell;JAMA,2016

4. Targeting practitioners: A review of guidelines, training, and policy in pain management;Barth;Drug Alcohol Depend,2017

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