An Interdisciplinary Academic Detailing Approach to Decrease Inappropriate Medication Prescribing by Physician Residents for Older Veterans Treated in the Emergency Department

Moss, Jason M.; Bryan, William E.; Wilkerson, Loren M.; King, Heather A.; Jackson, George L.; Owenby, Ryan K.; Houtven, Courtney Harold Van; Stevens, Melissa B.; Powers, James S.; Vaughan, Camille P.; Hung, William; Hwang, Ula; Markland, Alayne D.; Sloane, Richard; Knaack, William; Hastings, S. Nicole

doi:10.1177/0897190017747424

Cited by 14 publications

(27 citation statements)

References 38 publications

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“…For example, VA providers in the emergency department who were paired with academic detailers reduced the rate of potentially inappropriate medications for older adults. 12 This study demonstrated the ability of academic detailing to adapt within a dynamic, face-paced practice environment such as emergency medical care. 12 Moreover, academic detailers are experienced practitioners with strong interposal skills and a deep understanding of clinical decision-making and are able to effectively engage a multitude of health care disciplines, thus expanding the potential for meaningful impact.…”

Section: Current Statementioning

confidence: 84%

“… 8 In addition, as part of its mission to improve health care access, the VA Pharmacy Benefits Management (PBM) Service developed a virtual academic detailing (e-Detailing) model to improve the dissemination of critical health care information to providers in a timely fashion. 10 , 11 , 12 , 9 This commentary will highlight the opportunities for leveraging academic detailing during a pandemic to deliver timely resources to frontline providers. We use the VA academic detailing program as a model for other large, integrated health care systems, but we believe that these opportunities could be adapted for other systems.…”

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confidence: 99%

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Virtual academic detailing (e-Detailing): A vital tool during the COVID-19 pandemic

Hoffman¹,

Shayegani²,

Spoutz³

et al. 2020

Journal of the American Pharmacists Association

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As the coronavirus disease (COVID-19) pandemic continues its course in 2020, telehealth technology provides opportunities to connect patients and providers. Health policies have been amended to allow easy access to virtual health care, highlighting the field’s dynamic ability to adapt to a public health crisis. Academic detailing, a peer-to-peer collaborative outreach designed to improve clinical decision-making, has traditionally relied on in-person encounters for effectiveness. A growth in the adoption of telehealth technology translates to increases in academic detailing reach for providers unable to meet with academic detailers in person. The U.S. Department of Veterans Affairs (VA) has used academic detailing to promote and reinforce evidence-based practices and has encouraged more virtual academic detailing (e-Detailing). Moreover, VA academic detailers are primarily clinical pharmacy specialists who provide clinical services and education and have made meaningful contributions to improving health care at VA. Amid the COVID-19 pandemic and physical isolation orders, VA academic detailers have continued to meet with providers to disseminate critical health care information in a timely fashion by using video-based telehealth. When working through the adoption of virtual technology for the delivery of medical care, providers may need time and nontraditional delivery of “evidence” before eliciting signals for change. Academic detailers are well suited for this role and can develop plans to help address provider discomfort surrounding the use of telehealth technology. By using e-Detailing as a method for both familiarizing and normalizing health professionals with video-based telehealth technology, pharmacists are uniquely poised to deliver consultation and direct-care services. Moreover, academic detailing pharmacists are ambassadors of change, serving an important role navigating the evolution of health care in response to emergent public health crises and helping define the norms of care delivery to follow.

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Section: Current Statementioning

confidence: 84%

mentioning

confidence: 99%

Virtual academic detailing (e-Detailing): A vital tool during the COVID-19 pandemic

Hoffman¹,

Shayegani²,

Spoutz³

et al. 2020

Journal of the American Pharmacists Association

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“…38 Previous research found that PCPs have either not heard of or used the Beers Criteria when prescribing medications for older adults. 39,40 One barrier to appropriate prescribing in older adults is a lack of formal education on older adult prescribing. 40 The Beers Criteria is an important resource for NPs that emphasizes the benefit of limiting inappropriate medication prescribing in older adults and aims to reduce polypharmacy.…”

Section: Discussionmentioning

confidence: 99%

Differences in Evaluating Fall Risk by Primary Care Provider Type

Mark¹,

Haddad²,

Burns³

2020

The Journal for Nurse Practitioners

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This study assessed differences in clinical fall risk assessment of older adults (65+) and clinical resources used by primary care providers (PCP). We used Porter Novelli's 2016 DocStyles survey to examine clinical behavior data from PCPs (n=1128). Compared to other practitioners, nurse practitioners (NP) reported a higher percentage of their patients were older adults. The majority of NPs reported screening for falls risk routinely, but most did not use standardized fall-risk assessments to assess risk factors. There were also differences in the types of clinical resources used by NPs and other PCPs to evaluate the safety profile of medications. Study Highlights • Fall risk screening, assessment, and intervention can prevent falls. • NPs were more likely than other PCPs to screen for fall risk at each wellness visit. • Less than half of providers reported using standardized fall-risk assessment tests. • Less than 16% of NPs use the Beers Criteria when prescribing medications. • Enhanced fall prevention training could improve patient care and health outcomes.

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“…An approach such as home care is strongly recommended by the World Health Organization for various countries with community-based service models, especially in developing countries [21,22]. Academic detailing or case conferences have been carried out in various countries as part of primary care [3,4,13,23,24]. Because the approaches discussed in this review are universal, they can be extended to developing countries in the context of existing services.…”

Section: Training Needs Of Pharmacistsmentioning

confidence: 99%

“…Canada, the United States, the United Kingdom, and Ireland have developed academic detailing as a form of education from pharmacists for doctors in the context of optimizing drug services for the elderly. In these countries, education through academic detailing provides promising results for improving medication prescriptions from doctors for the elderly [2][3][4]. Educational activities that are needed and can be done by pharmacists in other forms include the provision of information on contraindications and drug interactions for the elderly seeking non-prescription drugs in pharmacies [5].…”

Section: Introductionmentioning

confidence: 99%

Innovative education approaches by geriatric pharmacists and their training needs: A systematic review

Nurfauzi¹,

Wahyono²,

Rahmawati³

et al. 2020

Trop. J. Pharm Res

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Purpose: To undertake a systematic review designed to observe the educational activities carried out by geriatric pharmacists innovatively, and also to ascertain their training needs.Methods: Articles were selected based on the following inclusion criteria: published in the years 2000 - 2019, designed as a randomized controlled trial (RCT), published in English language, contained educational activities carried out by pharmacists, and contained training requirements for pharmacists. The exclusion criteria were as follows: did not mention educational activities, only examined and assessed economic aspects, and used qualitative studies. This study analyzed nine articles from PUBMED, Scopus and Google Scholar that met the inclusion criteria.Results: Comprehensive education consisting of approaches such as interviews, discussions, case conferences, demonstrations, and goal-setting techniques provided innovations to medication review and pharmaceutical care plans. Seminar and e-learning were approaches to innovative problem-based education. Pharmacists needed training on medication review, education techniques for geriatrics, clinical collaboration, and geriatric pharmacotherapy.Conclusion: Pharmacist chose comprehensive and problem-based education approaches innovatively which require training in treatment management as well as professional relationship skills as educators, and based on the perspective of elderly needs. Keywords: Geriatric, Pharmacist, Education, Training, Innovative approaches

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An Interdisciplinary Academic Detailing Approach to Decrease Inappropriate Medication Prescribing by Physician Residents for Older Veterans Treated in the Emergency Department

Abstract: Academic detailing led by a physician-pharmacist pair resulted in improved confidence in physician residents' ability to prescribe safely in an older adult ED population and was associated with a statistically significant decrease in PIM rates.

Cited by 14 publications

References 38 publications

Virtual academic detailing (e-Detailing): A vital tool during the COVID-19 pandemic

Virtual academic detailing (e-Detailing): A vital tool during the COVID-19 pandemic

Differences in Evaluating Fall Risk by Primary Care Provider Type

Innovative education approaches by geriatric pharmacists and their training needs: A systematic review

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