Comparison of naloxone prescribing patterns due to educational outreach conducted by full-time and part-time academic detailers at the U.S. Veterans Health Administration

Bounthavong, Mark; Harvey, Michael; Kay, Chad L.; Lau, Marcos K.; Wells, Daina L; Himstreet, Julianne; Popish, Sarah J.; Oliva, Elizabeth M.; Christopher, Melissa L.D.

doi:10.1016/j.japh.2019.11.010

Cited by 6 publications

(1 citation statement)

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“…13 As part of the Veterans Administration programming, providers who engaged in academic detailing services were significantly more likely to prescribe naloxone, relative to those who did not. 3 Because the Military Health System implements their OEND program through a train-the-trainer approach and based on the Veterans Administration OEND program, future comparative analyses are warranted because the Military Health System does not have academic detailing services. In addition to programming improvements, health care systems may need to consider additional mechanisms to increase naloxone prescribing practices.…”

Section: Discussionmentioning

confidence: 99%

Naloxone prescribing practices in the Military Health System before and after policy implementation

Pakieser

Peters

Tilley

et al. 2021

PR9

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Introduction: Despite public health campaigns, policies, and educational programs, naloxone prescription rates among people receiving opioids remains low. In June 2018, the U.S. Military Health System (MHS) released 2 policies to improve naloxone prescribing.Objectives: The objective of this study was to examine whether the policies resulted in increased naloxone coprescription rates for patients who met the criteria for 1 or more risk indicators (eg, long-term opioid therapy, benzodiazepine coprescription, morphine equivalent daily dose $50 mg, and elevated overdose risk score) at the time of opioid dispense. Methods: Prescription and risk indicator data from January 2017 to February 2021 were extracted from the MHS Data Repository. Naloxone coprescription rates from January 2017 to September 2018 were used to forecast prescribing rates from October 2018 to February 2021 overall and across risk indicators. Forecasted rates were compared with actual rates using Bayesian time series analyses. Results: The probability of receiving a naloxone coprescription was higher for patients whose opioid prescriber and pharmacy were both within military treatment facilities vs both within the purchased-care network. Bayesian time series results indicated that the number of patients who met the criteria for any risk indicator decreased throughout the study period. Naloxone prescribing rates increased across the study period from ,1% to 20% and did not significantly differ from the forecasted rates across any and each risk indicator (adjusted P values all .0.05). Conclusion: Future analyses are needed to better understand naloxone prescribing practices and the impact of improvements to electronic health records, decision support tools, and policies.

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Section: Discussionmentioning

confidence: 99%