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Impacting the Prescribing of Opioids through Academic Detailing

通过学术细节影响阿片类药物的处方

基本信息

批准号：
10339309
负责人：
ALAN SIMON PICKARD
金额：
$ 76.76万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-30 至 2022-09-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10339309
关键词：
Impacting Prescribing Opioids through Academic

项目摘要

1 Academic detailing (AD) programs that educate providers on the appropriate prescribing of opioids have the 2 potential to improve health outcomes and patient care, but the extent to which AD is effective for this purpose 3 is not well established. The long-term goal of the proposed research is to improve the management of 4 patients with chronic pain while reducing fatal and non-fatal opioid overdoses. This goal will be accomplished 5 by implementing and evaluating AD programs delivered to primary care providers on the appropriate 6 management of chronic non-cancer pain. The objective is to improve appropriateness of opioid prescribing by 7 primary care providers in Illinois. The central hypothesis is that one-on-one AD visits by academic detailers 8 will improve appropriate opioid prescribing by primary care providers and enhance their use of the State 9 Prescription Drug Program (PMP). The rationale for the proposed research is rooted in the need to generate 10 evidence on the effectiveness of AD programs to improve opioid prescribing and provide resources to 11 successfully implement them. This work will be accomplished by building on pilot AD programs in the 12 Chicagoland and Southern Illinois regions that we successfully implemented in collaboration with the State of 13 Illinois PMP. The proposed research will rigorously evaluate the effectiveness of two different AD programs in 14 Illinois. The specific aims are: 1) to evaluate the short-term (6 month) impact of an AD program involving 2 15 visits on opioid prescribing patterns and PMP utilization among primary care providers; 2) to determine the 16 longer-term effectiveness (12 months) of a more sustained AD program (i.e. more than two visits); 3) to 17 develop an online toolkit of accessible resources for AD programs on the safe and appropriate management of 18 patients with chronic pain for use by health-systems and state/local health departments. The proposed 19 research is innovative in the design of the AD visit on opioid prescribing, including individualized opioid 20 metrics that compare provider prescribing to local norms using Illinois PMP data, use of validated measures to 21 assess intention to change opioid prescribing behavior as a result of the AD visit, and program evaluation 22 using a stepped-wedge cluster-randomized design. Our successful experience in implementing pilot AD 23 programs in the state as part of Illinois' CDC prevention for states activities and our established relationship 24 with the Illinois PMP and health-systems throughout Illinois make us well positioned to evaluate the impact of 25 AD on opioid prescribing activities. The proposed research is significant to combating the opioid epidemic 26 because evidence to support the effectiveness of AD programs and their design and delivery is critical to 27 identifying approaches that modify prescribing behaviors and improve the management of patients with pain. 28 The expected outcome is to positively impact clinical decision-making and patient outcomes in Illinois and 29 address evidence gaps on the effectiveness of AD programs that leverage relationships with state PMPs to 30 improve opioid prescribing and pain management by healthcare providers.

1教育提供者有关阿片类药物的适当处方的学术详细说明(AD)计划 2改善健康结果和病人护理的潜力，但AD对此目的有效的程度 3.不是很成熟。拟议研究的长期目标是改善对 4患者慢性疼痛，同时减少致命性和非致命性阿片类药物过量。这个目标一定会实现的 5通过实施和评估提供给初级保健提供者的AD计划 6慢性非癌性疼痛的管理。目的是通过以下方式提高阿片类药物处方的适当性伊利诺伊州的7个初级保健提供者。中心假设是学术细节人员一对一的广告访问 8将改善初级保健提供者的适当阿片类药物处方，并加强他们对国家的使用 9处方药计划(PMP)。拟议研究的理由是需要生成 10关于AD计划改善阿片类药物处方和提供资源的有效性的证据 11.成功实施。这项工作将通过建立在 12个芝加哥和南伊利诺伊州地区，我们与伊利诺伊州合作成功实施 13伊利诺伊州PMP。拟议的研究将严格评估两种不同AD计划在伊利诺伊州14号具体目标是：1)评估涉及2个月的AD计划的短期(6个月)影响 15次关于初级保健提供者的阿片类药物处方模式和PMP使用情况的访问；2)确定 16更持久的AD方案的较长期有效性(12个月)(即两次以上访问)；3) 17为AD方案开发关于安全和适当管理的可访问资源的在线工具包 18名慢性疼痛患者，供卫生系统和州/地方卫生部门使用。建议数 19项研究在阿片类药物处方AD访问的设计上具有创新性，包括个体化阿片类药物使用伊利诺伊州PMP数据将供应商处方与当地标准进行比较的20个指标，使用经过验证的指标来 21评估由于AD访问而改变阿片类药物处方行为的意向，并对计划进行评估 22采用阶梯楔形整群随机设计。我们实施AD试点的成功经验作为伊利诺伊州疾病预防控制中心各州活动和我们建立的关系的一部分，该州的23个项目 24伊利诺伊州的PMP和整个伊利诺伊州的医疗系统使我们能够很好地评估 25阿片类药物处方活动。这项拟议的研究对抗击阿片类药物流行具有重要意义 26因为支持AD计划及其设计和交付有效性的证据对于 27确定改变处方行为和改善疼痛患者管理的方法。 28预期结果是积极影响伊利诺伊州的临床决策和患者结果 29解决AD计划有效性方面的证据空白，这些计划利用与州PMP的关系来 30改善医疗保健提供者的阿片类药物处方和疼痛管理。