A Brief Overview of Academic Detailing in Canada: Another Role for Pharmacists

Jin, Margaret; Naumann, Terryn L.; Regier, Loren; Bugden, Shawn; Allen, Michael; Salach, Lena; Chelak, Kristen; Blythe, Nancy; Gagnon, Antony; Dolovich, Lisa

doi:10.3821/145.3.cpj142

Cited by 22 publications

(13 citation statements)

References 39 publications

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“…In contrast, requiring or encouraging staff at methadone programs to advise patients of buprenorphine availability was not associated with the number of waivered physicians. Our findings that policies with more detailed guidance to providers were associated with more waivered physicians, in contrast to policies with less specific guidance to providers, are consistent with quality of care studies, which have found that detailed provider guidance, such as that occurring in academic detailing (Jin et al, 2012; Soumerai, 1998), can result in providers changing behavior. It may also be that efforts to enhance the use of buprenorphine through methadone programs, whose patients are clinically different than individuals receiving buprenorphine,(Baxter, Clark, Samnaliev, Leung, & Hashemi, 2011) and which already have an established infrastructure and alternative business model to provide an alternative opioid agonist treatment, are less effective than initiatives targeting broader groups of providers.…”

Section: Discussionsupporting

confidence: 88%

Supply of buprenorphine waivered physicians: The influence of state policies

Stein

Gordon

Dick

et al. 2015

Journal of Substance Abuse Treatment

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Buprenorphine, an effective opioid use disorder treatment, can be prescribed only by buprenorphine-waivered physicians. We calculated the number of buprenorphine-waivered physicians/100,000 county residents using 2008–11 Buprenorphine Waiver Notification System data, and used multivariate regression models to predict number of buprenorphine-waivered physicians/100,000 residents in a county as a function of county characteristics, state policies and efforts to promote buprenorphine use. In 2011, 43% of US counties had no buprenorphine-waivered physicians and 7% had 20 or more waivered physicians. Medicaid funding, opioid overdose deaths, and specific state guidance for office-based buprenorphine use were associated with more buprenorphine-waivered physicians, while encouraging methadone programs to promote buprenorphine use had no impact. Our findings provide important empirical information to individuals seeking to identify effective approaches to increase the number of physicians able to prescribe buprenorphine.

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Section: Discussionsupporting

confidence: 88%

Supply of buprenorphine waivered physicians: The influence of state policies

Stein

Gordon

Dick

et al. 2015

Journal of Substance Abuse Treatment

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“…The Canadian Academic Detailing Collaboration was founded in 2003 initially with five programmes. This collaboration works in partnership with the Canadian Agency for Drugs and Technologies in Health – CADTH, which develops the information to be disseminated by the detailers . The programmes were developed by a pharmacist alone or in a group containing also a specialist physician, urban and rural family physicians.…”

Section: Resultsmentioning

confidence: 99%

Implementation of clinical guidelines in Brazil: should academic detailing be used?

Costa

Almeida-Brasil

Godman

et al. 2016

J Pharm Health Serv Res

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Objective The Brazilian National Health System provides high cost medicines through the Specialized Component of Pharmaceutical Assistance in accordance with the adherence to agreed Clinical Guidelines. However, physician compliance to these Guidelines, as well as the barriers and facilitators related to them and the influence on the subsequent quality of care provided is unknown. Consequently, the objectives of this article are to undertake a review of international experiences and scientific publications of a strategy to disseminate and communicate guidelines to physicians through Academic Detailing. Subsequently, use the findings to develop and conduct a pilot Academic Detailing Programme in Brazil targeting specialists who prescribe medicines for patients with Alzheimer's disease, which are part of the Specialized Component of Pharmaceutical Assistance. Methods Review international experiences and scientific publications relating to academic detailing based on a thorough review of available literature including publications known to the coauthors. Develop and monitor physician acceptance of academic detailing for patients with Alzheimer's disease and the impact on future prescribing. Key findings Based on the lessons learnt from the international experience and review, coupled with the initial experiences in Brazil, we conclude that conducting academic detailing to enhance the implementation and dissemination of clinical protocols and therapeutic guidelines in Brazil is worthwhile. We will be closely monitoring the outcome of the pilot academic detailing programme as a basis for developing future programmes to further improve the quality of prescribing in Brazil. Conclusions Findings from the experiences are encouraging. This will be further explored to provide a basis for this approach in the future.

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“…10 In 2010 and 2013, respectively, the Dalhousie and BC Provincial Academic Detailing Services developed courses on opioid use in chronic non-cancer pain. 11,12 In spite of individual provincial efforts, Canadian academic detailing on opioid use in chronic non-cancer pain does not appear to be widespread. We, therefore, recommend that licensed physicians in Canada who are currently prescribing opioids for chronic non-cancer pain be targeted for appropriate CME through academic detailing services.…”

Section: Education Strategies To Improve Opioid Stewardshipmentioning

confidence: 99%

“…9 Additionally, use of academic detailing for CME should be augmented and funds should be allocated for opioid related material development. [10][11][12] To comprehensively address opioid abuse disorder, changes to clinical practice, public health policies, and funding allocation are surely required. Therefore, while improving prescribing practices alone is insufficient to mitigate opioid addiction, empowering physicians to prescribe appropriately will promote health and save lives.…”

Section: Conclusonmentioning

confidence: 99%

Chronic pain management and the development of opioid use disorder

Robinson¹,

Yu²,

Patel³

2018

UWOMJ

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Chronic pain is a common condition that impacts quality of life and often precipitates the need for medical attention. Despite evidence that long-term opioid use provides limited relief, prescription opioid therapy remains a cornerstone in the medical management of chronic non-cancer pain. Presently, 13% of Canadians are prescribed opioids for pain management, and physicians play a crucial role in preventing the development of opioid use disorders. However, Canadian physicians lack knowledge of and comfort with evidence-based principles of opioid stewardship. In this article, we aim to highlight ongoing Canadian efforts to address physician discomfort and improve clinical practice. We focus on 2017 Canadian guidelines that provide clinicians with evidence-based recommendations for opioid use in chronic non-cancer pain management. In addition, we call attention to provincial efforts to implement physician accountability measures. In reviewing the existing literature, we uncovered inadequacies in pain management curricula within the Canadian undergraduate and continuing medical education (CME) systems. We consulted the educational practices of the European Pain Federation and the Centers for Disease Control and Prevention to make recommendations for improvement to current Canadian pain curricula. Based on our findings, we recommend that (1) Canadian medical institutions expand upon current core pain curricula, (2) pain management education be made compulsory, (3) academic detailing be emphasized as a means of CME, and (4) multidisciplinary non-medical management of chronic pain be featured more extensively.

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A Brief Overview of Academic Detailing in Canada: Another Role for Pharmacists

Cited by 22 publications

References 39 publications

Supply of buprenorphine waivered physicians: The influence of state policies

Supply of buprenorphine waivered physicians: The influence of state policies

Implementation of clinical guidelines in Brazil: should academic detailing be used?

Chronic pain management and the development of opioid use disorder

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