Feasibility and acceptability of virtual academic detailing on opioid prescribing.
Feasibility and acceptability of virtual academic detailing on opioid prescribing.
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DOI：
10.1016/j.ijmedinf.2020.104365
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发表时间：
2021-03
影响因子：
4.9
通讯作者：
Pickard AS
中科院分区：
文献类型：
--
作者：
Smart MH;Mandava MR;Lee TA;Pickard AS
COVID-19期间的社交距离要求对传统的学术细节提出了挑战，这通常涉及面对面的同伴教育访问，以改善患者的治疗效果。主要的替代方案是通过基于网络的技术进行虚拟学术详细介绍，但这种方法充满了许多挑战。本研究的目的是探讨一个虚拟的学术细化程序中实施的医疗保健提供者的可行性和可接受性。学术详细计划的重点是适当的阿片类药物处方和慢性非癌症疼痛管理的样本提供者。最初的面对面访问之后，是长达8周的虚拟访问。利用电视会议进行虚拟访问，电话作为备用。可行性进行了评估，是否虚拟访问可以发生，和可接受性进行了评估提供者的满意度。使用了经验证的提供者对学术细节满意度（PSAD）和细节访问有效性评估（DAVE）以及5分Likert类型量表。分数越高，满意度越高，感知效果越好。使用非参数和参数统计检验比较访视间和组间的工具汇总评分。两次访视之间的成对分析仅包括参与两次访视并完整完成两次调查的提供者的仪器响应。在计划的141次访问中，有127次（90%）完成了首次面对面访问，调查答复率为96%。在计划的120次虚拟随访中，进行了92次（77%），收集了56次调查（61%）。对初始和后续虚拟学术详细访问的满意度很高，但是，在参与两次访问并完成调查的提供者（n = 50）中，初始访问的得分略高（平均差异=-2.94 [95%置信区间：-4.38，-1.50]，p < 0.001）。两次访视的细节感知没有显著差异，如量表总分（0.05 [-0.56，0.66]，p = 0.86）和两个单独报告的与可行性（0.07 [-0.29，0.42]，p = 0.72）和谈话（-0.05 [-0.28，0.17]，p = 0.63）相关的项目所示。41次（44.6%）虚拟访问是使用WebEx进行的，其中可以共享访问内容的视频和屏幕，而其余51次（55.4%）是使用电话进行的。WebEx与电话访问之间的提供者满意度没有显著差异（-1.47 [-4.99，2.05]，p = 0.82）。提供者满意度也不受详细人员报告的任何技术困难的影响（-0.04 [-3.30，3.38]，p = 0.98）。结果稍微倾向于亲自访问，并建议虚拟详细访问需要纳入策略，最大限度地减少技术困难，并防止参与者默认为不太有利的技术。未来的研究机会包括评估AD计划的虚拟与面对面交付对提供者阿片类药物处方行为等结果的有效性。
Social distancing requirements during COVID-19 pose a challenge to conducting traditional academic detailing, which typically involves in-person peer education visits to improve patient outcomes. The main alternative is to conduct virtual academic detailing delivered through web-based technology, but this approach is fraught with many challenges. This study aimed to examine the feasibility and acceptability of a virtual academic detailing program implemented among health care providers. The academic detailing program focused on appropriate opioid prescribing and chronic non-cancer pain management among a sample of providers. An initial in-person visit was followed by a virtual visit up to 8 weeks later. Videoconferencing was used to conduct the virtual visit with telephone as a backup. Feasibility was assessed whether the virtual visits could happen, and acceptability was assessed by provider satisfaction. Validated measures of Provider Satisfaction with Academic Detailing (PSAD) and Detailer Assessment of Visit Effectiveness (DAVE) with a 5-point Likert-type scale were used. Higher scores corresponded to higher satisfaction and greater perceived effectiveness. Non-parametric and parametric statistical tests were used to compare instrument summary scores across visits and between groups. Pairwise analyses across visits only included instrument responses for providers who participated in both visits and completed both surveys in their entirety. There were 127 (90 %) initial in-person visits completed out of 141 visits scheduled, with a survey response rate of 96 %. Out of 120 virtual follow-up visits scheduled, 92 (77 %) were conducted, and 56 surveys (61 %) were collected. There was a high level of satisfaction with the initial and follow up virtual academic detailing visits, though, among providers who participated in both visits and had completed surveys (n = 50), initial visits had slightly higher scores (mean difference = −2.94 [95 % Confidence intervals: −4.38, −1.50], p < 0.001). There was no significant difference in detailer perception across the two visits as seen in the scale summary score (0.05 [−0.56, 0.66], p = 0.86) and two individually reported items related to feasibility (0.07 [−0.29, 0.42], p = 0.72) and conversation (−0.05 [−0.28, 0.17], p = 0.63). Forty-one (44.6 %) virtual visits were conducted using WebEx, where video and screen sharing of visit content was possible, while the remaining 51 (55.4 %) were conducted using a telephone. There was no significant difference in provider satisfaction between WebEx vs. telephone visits (-1.47 [-4.99, 2.05], p = 0.82). Provider satisfaction was also not impacted by any technical difficulties as reported by the detailer (-0.04 [-3.30, 3.38], p = 0.98). The results slightly favor in-person visits and suggest that virtual detailing visits need to incorporate strategies that minimize technical difficulties and prevent participants from defaulting to less favorable technology. Future research opportunities include evaluating the effectiveness of a virtual versus in-person delivery of AD program on outcomes such as providers’ opioid prescribing behavior.
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影响因子：
5.9
作者：
Saffore, Christopher D.;Tilton, Sarette T.;Sharp, Lisa K.
通讯作者：
Sharp, Lisa K.
CDC规定慢性疼痛的阿片类药物的指南 - 美国，2016年。
DOI：
10.1001/jama.2016.1464
发表时间：
2016-04-19
期刊：
JAMA
影响因子：
--
作者：
Dowell D;Haegerich TM;Chou R
通讯作者：
Chou R
影响因子：
2.9
作者：
Hartung DM;Hamer A;Middleton L;Haxby D;Fagnan LJ
通讯作者：
Fagnan LJ
影响因子：
4.7
作者：
Smith, Anthony C.;Thomas, Emma;Caffery, Liam J.
通讯作者：
Caffery, Liam J.
影响因子：
5.5
作者：
Bowen, Deborah J.;Kreuter, Matthew;Spring, Bonnie;Cofta-Woerpel, Ludmila;Linnan, Laura;Weiner, Diane;Bakken, Suzanne;Kaplan, Cecilia Patrick;Squiers, Linda;Fabrizio, Cecilia;Fernandez, Maria
通讯作者：
Fernandez, Maria