1. Impact of Academic Detailing in the Chicagoland Region: A Pilot Study
A. Simon Pickard, PhD
Todd A. Lee, PharmD, PhD

2. Academic Detailing Focused on one-on-one educational outreach
Provides evidence-based information
Effective at modifying behavior
Prescribing antihypertensives
Prescribing antimicrobials
Alcohol use disorder treatment
HIV testing
Prevention for States activities
Increased use of academic detailing
Strategy for modifying prescribing behavior

3. Study Aims STUDY AIMS Primary aim
To determine the feasibility and impact of academic detailing visits on opioid prescribing activities among PCPs from a large health system in the Chicagoland-area
Secondary aims
To explore PCPs experience and satisfaction with academic detailing visits
Identify potential barriers and factors for success of academic detailing visits
Measure quality of interaction based on perception of academic detailers

4. PICOTS Framework PICOTS FRAMEWORK POPULATION
Primary care providers (PCPs) from a large health system in the Chicagoland area (AMITA Health)
INTERVENTION
Academic detailing visits focused on past prescribing and CDC Guidelines for Prescribing Opioids for Chronic Pain
COMPARATOR
Group of non-AMITA primary care physicians in the Chicagoland area
OUTCOMES
Measures of opioid prescribing
TIMEFRAME
May – August 2018
SETTING
PCP practice locations in the Chicagoland area (AMITA Health and control sites)

5. Study Design Quasi-experimental study
Pre/post assessment of opioid prescribing indicators
Prescribing measures 6 months before intervention and 6 months after intervention
Measures in both intervention and control groups
Difference-in-difference approach to evaluate the effectiveness of the intervention

6. Intervention Group AMITA Health primary care providers
Around 300 eligible PCPs
Licensed healthcare professional with prescriptive authority (MD, DO, NP, PA)
Excluding residents from intervention due to timing

7. Comparison Group
Randomly selected group of non-AMITA PCPs in the Chicagoland area
Matching at the zip code level and provider type
Unknowns / Issues –
Within organization interventions
Constrain comparison group to another health system

8. Intervention
Two academic detailing visits by trained academic detailers
Visits will be minute face-to-face encounters
Visits will include following elements
Greetings/introductions
Review of PCPs opioid prescribing metrics (“dashboard” metrics)
Key aspects of CDC Guidelines (will be prioritized based on input from AMITA, PMP, NarCAD training)
Assessment
Repeat visit about 8 wks following initial visit

9. Academic Detailers
Mix of graduate students and current PharmD students
PharmD students recruited through a competitive process
Required to give 10 minute presentation on CDC Guidelines
Evaluated on a number of criteria
Train-the-trainer model
3-4 individuals attending NarCAD training session
April 30 – May 1
Will train detailers based on NarCAD model

10. Dashboard Metrics Provider Level Metrics
Number of prescriptions for controlled substances, by class
Mean day supply per opioid prescription
Mean MMEs per opioid prescription
Rate of co-prescribing of opioids and benzodiazepines as a proportion of total number of opioid prescriptions
Total number of MMEs prescribed
Number of prescriptions with >31 day supply for opioids
Proportion of opioid Rxs with MMEs ≥90
Proportion of opioid Rxs with MMEs between 50-90
Proportion of opioid Rxs with MMEs <50
Number of Rxs for long-acting/extended release opioids
Number of naloxone Rxs

11. Timeline
Visit 1
Visit 2
May
June
July
August

12. Assessments Dashboard Metrics
Physician administered survey after visit
Detailer measures of perception of visit

13. Input from Advisory Committee
Any previous experience with academic detailing?
Interest in Expert panel? Input valued on
Physician-completed survey
Experience with PMP
Attitude towards opioid prescribing
Satisfaction with AD visit
Detailer perception of AD visit
Prescriber awareness of PMP and CDC guidelines
Prescriber availability for visit
Interest, courtesy, positive/negative attitude about visit
Suggestions for implementation of Delta region ITV
Experienced SIU faculty?
Practicality of sending Chicago-area trained team?