1. Bevin K. Shagoury, Communications & Education Director
Academic Detailing
For the Opioid Crisis:
An Overview
January 26, 2018
Bevin K. Shagoury, Communications & Education Director
National Resource Center for Academic Detailing
Division of Pharmacoepidemiology and Pharmacoeconomics [DoPE]
Brigham and Women’s Hospital | Harvard Medical School
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2. The Goal of Academic Detailing
Closing the gap between:
Best Available Evidence
Actual Clinical Practice
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3. Clinicians Want the Best Outcomes
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4. Primary Care Burnout: Stats
Automated interventions hitting point of diminishing returns
Pay-for-Performance contributing to burnout
10% of physicians
identified their burnout as
“so severe I’m thinking of leaving medicine.”
MedScape, Mayo Clinic, VITAL Worklife2015

5. Academic Detailing can offer:
Clinicians Value:
Academic Detailing can offer:
Continuous engagement & sense of purpose
Ability to reinvigorate primary care
Continued learning & tools around complex topics (e.g. opioid safety)
Time
Support
Mastery
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6. Bringing Evidence-based Medicine to Clinicians
Clinicians need high quality data that is:
Relevant to clinical problems
In a practical, easy-to-use format
Customized to their clinical setting
Focused on real-world decisions
Academic detailing can meet these needs.

7. Trusted Clinical Information
Academic Detailing
Industry
Great
Communicators
Academia
Trusted Clinical Information
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8. Academic Detailing Evidence Base
Evaluated extensively in multiple settings
Large evidence base confirms efficacy:
A large systematic review in 2007 combined 69 studies and confirmed efficacy of AD
New NHLBI systematic review in Jan showed AD visits effective in improving both process of care and clinical outcomes
*O’Brien MA, Rogers S, et al. Cochrane, Database of Systematic Reviews 2007
**Chan W, Pearson T, et al. AHA Circulation Journal, 2017
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9. AD is Adaptable for Diverse Clinical Needs
Long term care
Opioid Stewardship & Safety
Cancer Screening
Pediatric Screening
HIV/STD Screening + Treatment
Chronic Disease Management
Smoking Cessation
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Mention learning from Australia, as well as the VA’s national program, here. Talk about opportunities for collaboration among NaRCAD and other US programs (like VA), CEP and CADC, and other international groups like Australia. 9

10. The Method of Academic Detailing
It’s educational outreach.
1:1 visits in the frontline clinician’s own office
A supportive service for better patient care
Information is provided interactively to:
Understand the clinician’s knowledge, attitudes, behavior
Keep the practitioner engaged while continuing to assess needs
The visit ends with specific practice-change recommendations.
Over time, the relationship is strengthened, based on trust and usefulness.

11. The Structure of a 1:1 Visit
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12. Examples of Messages for Clinicians
to Improve Outcomes for Opioid Use Disorder (OUD)
Where there are high rates of opioid prescribing:
“You can offer evidence-based treatments, such as medication-assisted treatment (MAT) and behavioral therapy, for your patients with OUD.”
“I can help you with the waiver application and management process to prescribe or dispense buprenorphine for opioid dependency treatment.”
Where there are high rates of opioid overdose:
“You can co-prescribe naloxone to your patients at high risk of overdose, and I have educational materials for your patients’ friends and families about how to administer it.”
“Avoiding concurrent prescribing of opioids and benzodiazepines lowers the risk of opioid overdose.”
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13. Elements of a Successful Program
Identifying gaps in care
Defining intervention goals
Recruiting & training detailers
Detailers visit providers 1:1
Evaluation & assessment
Building capacity & sustainability
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14. Ongoing Technical Support
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17. Connect with us narcad.org
Questions?
Connect with us narcad.org
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