Academic detailing interventions for opioid-related outcomes: a scoping review

Abstract

Background Academic detailing (AD) is a tailored, interactive educational outreach intervention that may improve patient outcomes. Insight into the design of AD interventions and the extent to which they are effective can help inform future AD-based programmes. The objective of this scoping review was to characterize opioid-focused AD interventions and describe their findings. Methods A scoping review focused on AD interventions for opioids was conducted in PubMed, EMBASE and CINAHL databases through July 1, 2021. Studies were eligible for inclusion if written in English, included interactive opioid-focused educational interventions, and were conducted either in person, virtually or via telephone. Four independent reviewers reviewed titles and abstracts. Data extraction from full-text publications was completed using a standardized form. Results Of 6086 articles initially identified, 22 articles met the inclusion criteria and 20 unique interventions were identified. The AD intervention was either delivered one-on-one ( n =16) or in a small, interactive group setting ( n =4). AD interventions varied in design. Effectiveness was evaluated in terms of opioid and naloxone prescribing rates, provider knowledge gaps, provider adherence to guidelines, and intervention feasibility. Sixteen (80%) interventions resulted in statistically significant improvement in one or more outcomes. Conclusion Generally, opioid-related AD was effective and programmes were primarily conducted one-on-one between pharmacists and primary care providers for 16–30 minutes. A variety of metrics and outcomes were used to assess the success/effectiveness of AD interventions, which is an important consideration in future studies as no single metric captures the effectiveness of an educational outreach-based intervention for pain management.

Improving rural and regional access to long-acting reversible contraception and medical abortion through nurse-led models of care, task-sharing and telehealth (ORIENT): a protocol for a stepped-wedge pragmatic cluster-randomised controlled trial in Australian general practice

“…Importantly, implementation of this intervention is supported by key activities that have proven to be successful in improving clinical practice in prior research studies 52 61–63. GPs and PNs will be provided with accredited training on LARC and medical abortion to enhance their clinical competencies to provide this care.…”

Top-down and bottom-up approaches to low-value care

“…When designing initiatives to reduce low-value care, it is important to appreciate that any strategy or component is unlikely to be effective across all quality and safety problems in general 9. Evidence shows that even frequently used components, like audit and feedback,18 academic detailing19 and policy interventions work some of the time but none work all the time, the observed effects are often modest and it is not always clear why the modest change occurred 9. In addition, some barriers faced in de-implementation interventions such as how clinicians handle diagnostic uncertainty may require adaptation or different components 20.…”

Alternatives to dental opioid prescribing after tooth extraction (ADOPT): protocol for a stepped wedge cluster randomized trial

“…In that context, this study will combine three elements to create a multicomponent intervention to modify prescriber behavior: [1] prescriber education using academic detailing [22,23], [2] standardized patient post-extraction instructions for distribution, and [3] blister packaged acetaminophen and ibuprofen for distribution.…”