Academic Detailing Increases Prescription Drug Monitoring Program Use Among Primary Care Practices

Details

• Alternative Title:
  J Am Pharm Assoc (2003)
• Personal Author:
  Ball, Sarah J. ; McCauley, Jenna A. ; Pruitt, Megan ; Zhang, Jingwen ; Marsden, Justin ; Barth, Kelly S. ; Mauldin, Patrick D. ; Gebregziabher, Mulugeta ; Moran, William P.
• Description:
  Background:
  
  Clinical review of a Prescription Drug Monitoring Program (PDMP) is considered a valuable tool for opioid prescribing risk mitigation; however, PDMP utilization is often low, even in states with mandatory registration and use policies.
  
  Objective:
  
  To evaluate the impact of an Academic Detailing (AD) outreach intervention on PDMP use among primary care prescribers.
  
  Methods:
  
  AD intervention was delivered to primary care based controlled substance prescribers (n=87) and their associated PDMP delegates (n=42) by a clinical pharmacist as one component of a large-scale, statewide initiative to improve opioid prescribing safety. Prescriber PDMP use behavior was assessed by prescriber self-report and analysis of objective 2016 – 2018 PDMP data regarding number of monthly report requests. We compared means between pre and post intervention using a paired t-test and plotted the monthly average reports over time to assess trend of mean reports over time. Generalized linear mixed model (GLMM) with a Negative Binomial distribution was used to assess the difference in the trend and magnitude of the combined count of reports for the entire sample and prescriber subsets that were segmented based on adoption status of PDMP.
  
  Results:
  
  The monthly mean of reports by combined prescribers and delegates significantly increased following the AD intervention (mean 28.1 pre vs. 53.0 post; p<0.0001), with the increase in delegate reports (mean 17.1 pre vs. 60.0 post; p<0.0001) driving the overall increase. Reports were requested 40.4 times more often than in the pre-intervention period (p<0.0001). Patterns of pre to post changes in mean monthly report requests differed by baseline PDMP adoption status.
  
  Conclusions:
  
  The AD intervention was transformative in terms of facilitating practice change to utilize delegates to run reports. Visits with both prescribers and delegates, including hands-on PDMP training and registration assistance, can be viewed as beneficial for practice facilitation.
  
  
• Subjects:
  Analgesics, Opioid Controlled Substances Humans Practice Patterns, Physicians' Prescription Drug Monitoring Programs Primary Health Care
• Source:
  J Am Pharm Assoc (2003). 61(4):418-424.e2
• Pubmed ID:
  33812783
• Pubmed Central ID:
  PMC8273068
• Document Type:
  Journal Article
• Funding:
  K23 DA036566/DA/NIDA NIH HHSUnited States/ ; P30 DK123704/DK/NIDDK NIH HHSUnited States/ ; U17 CE002730/CE/NCIPC CDC HHSUnited States/
• Volume:
  61
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8a2aff3df260d265c0b975a79f1afbc9c3126151d7cf90de5a819c2b82067b4f
• Download URL:
  https://stacks.cdc.gov/view/cdc/108087/cdc_108087_DS1.pdf
• File Type:
  [PDF - 216.57 KB ]