Exploring Providers’ Perception to Naloxone Education for Opioid Overdose After Receiving Academic Detailing at the U.S. Department of Veterans Affairs

2021 ◽  
pp. 089719002110532
Author(s):  
Mark Bounthavong ◽  
Melissa L. D. Christopher ◽  
David L. Veenstra ◽  
Anirban Basu ◽  
Emily Beth Devine
Keyword(s):  
Online Survey ◽  
Primary Care Providers ◽  
Veterans Affairs ◽  
Domain Score ◽  
Current Evidence ◽  
Opioid Overdose ◽  
Academic Detailing ◽  
Department Of Veterans Affairs ◽  
Care Providers ◽  
The U.S

Introduction The U.S. Department of Veterans Affairs (VA), in partnership with the Opioid Overdose Education and Naloxone Distribution (OEND) Program, implemented the National Academic Detailing Service to deliver naloxone education to providers with patients at-risk for opioid-related overdose. Methods We administered a 26-item online survey to VA providers to explore their perceptions about prescribing naloxone for opioid overdose emergencies and their experience with academic detailing between August 2017 and April 2018. Responses were analyzed using descriptive statistics to (1) explore their current perceptions of naloxone prescribing and their experience with academic detailing, (2) identify differences across provider types [primary care providers (PCP), specialists, and others], and (3) assess perceived naloxone prescribing behavior change after an academic detailing visit. Results Providers (N = 137) indicated that they were practicing at a level that was consistent with VA goals to promote take-home naloxone to reverse opioid-related overdose events. Average domain scores were similar across PCP, specialist, and other provider types. Specialists reported a higher average attitude domain score (+.56, P = .011) and perceived barriers domain score (+.82, P = .009) than PCPs. Most providers agreed that they prescribed naloxone more frequently due to academic detailing (53%) and indicated that they synthesized information from the academic detailer to change their naloxone prescribing practice (60%). Discussion VA providers’ perceptions of take-home naloxone were aligned with current evidence-based practice. Moreover, providers reported increasing their naloxone prescribing and synthesizing OEND-related information after an academic detailing interaction. Understanding providers’ perceptions can be used to improve and enhance the academic detailing program’s effectiveness.

scholarly journals Telemedicine Specialty Support Promotes Hepatitis C Treatment by Primary Care Providers in the Department of Veterans Affairs

2017 ◽  
Vol 130 (4) ◽  
pp. 432-438.e3 ◽  
Author(s):  
Lauren A. Beste ◽  
Thomas J. Glorioso ◽  
P. Michael Ho ◽  
David H. Au ◽  
Susan R. Kirsh ◽  
...  
Keyword(s):  
Primary Care ◽  
Hepatitis C ◽  
Primary Care Providers ◽  
Veterans Affairs ◽  
Department Of Veterans Affairs ◽  
Care Providers ◽  
Hepatitis C Treatment

scholarly journals 148 Sustainability of a Benzodiazepine Deprescribing Intervention with Primary Care Providers in a University-Based Community Clinic

CNS Spectrums ◽  
2020 ◽  
Vol 25 (2) ◽  
pp. 294-295
Author(s):  
Lois M. Platt ◽  
Teresa A. Savage
Keyword(s):  
Primary Care ◽  
Pharmaceutical Company ◽  
Low Income ◽  
Primary Care Providers ◽  
The United States ◽  
Health Concern ◽  
Current Evidence ◽  
Academic Detailing ◽  
Care Providers ◽  
Community Clinic

Abstract:Study Objectives:In light of the opioid crisis, less attention has been focused on the long-term misuse of benzodiazepines (BZD) for anxiety and sleep disorders. The purpose of this study was to determine the sustainability of positive results (an 80% decrease in BZD prescribing) following a deprescribing intervention with primary care providers working with a low-income population at a Midwestern university-based community clinic.Method:All de-identified BZD prescriptions written by providers at the community clinic were captured using the electronic medical record. A BZD equivalency chart was used to compare the relative potencies of BZD commonly prescribed by the clinic. Each prescription was converted to a single number: the diazepam equivalent (DE). This number takes into account the potency of the drug (using diazepam as the standard), the dose of the drug, number of tablets dispensed and number of refills. The number of DE prescribed was tallied every 30 days for 6 months following the completion of a quality improvement BZD deprescribing intervention. The original intervention was implemented in 2018, with the goal of decreasing the prescription of BZD by clinic primary care providers to outpatients for insomnia or anxiety. The brief intervention combined academic detailing and pharmaceutical company detailing with a deprescribing message. Providers were given current evidence about alternatives to BZD, deprescribing schedules, and brain-storming opportunities about the management of patient concerns and resistance to change. Posters with alternatives to BZD were hung in the main provider office at the clinic. Food and “No Benzo” logo merchandise (mugs, pens) were provided to attendees of the intervention and clinic nurses. Thirty days after the intervention, the number of DE prescribed decreased by 80%.Results:Benzodiazepine prescribing (measured in DE) continued to decrease every 30 days for six months to 92-93% of pre-intervention numbers.Conclusions:Follow up of a 2018 intervention revealed sustainability of the effect of a significant decrease in benzodiazepine (BZD) prescribing in a community clinic. A brief BZD deprescribing intervention using a combination of academic detailing and pharmaceutical company detailing designed to persuade prescribers to change their behavior was effective in influencing providers to decrease the amount of BZD they prescribe. The desired result (an 80% decrease in BZD prescribing) was achieved following the original 30-day intervention. Prescription numbers continued to decrease over the next six months (to 92-93% of pre-intervention numbers), which indicates that the deprescribing intervention may have had a sustainable positive effect on provider prescribing behavior. This intervention is easy to implement and may decrease BZD prescribing, which addresses the overuse/misuse of BZD, a significant public health concern in the United States.Funding Acknowledgements: Personal funds only

Clinical dashboard development and use for academic detailing in the U.S. Department of Veterans Affairs

2019 ◽  
Vol 59 (2) ◽  
pp. S96-S103.e3 ◽  
Author(s):  
Marcos K. Lau ◽  
Mark Bounthavong ◽  
Chad L. Kay ◽  
Michael A. Harvey ◽  
Melissa L.D. Christopher
Keyword(s):  
Veterans Affairs ◽  
Academic Detailing ◽  
Department Of Veterans Affairs ◽  
The U.S

Patient perspectives on an opioid overdose education and naloxone distribution program in the U.S. Department of Veterans Affairs

2015 ◽  
Vol 37 (1) ◽  
pp. 118-126 ◽  
Author(s):  
Elizabeth M. Oliva ◽  
Andrea Nevedal ◽  
Eleanor T. Lewis ◽  
Matthew D. McCaa ◽  
Michael F. Cochran ◽  
...  
Keyword(s):  
Veterans Affairs ◽  
Patient Perspectives ◽  
Opioid Overdose ◽  
Department Of Veterans Affairs ◽  
The U.S

scholarly journals Determinants of Workforce Preparedness during Pandemics Among Healthcare Workers at the U.S. Department of Veterans Affairs

2021 ◽  
Vol 12 ◽  
pp. 215013272110047
Author(s):  
Michelle D. Balut ◽  
Claudia Der-Martirosian ◽  
Aram Dobalian
Keyword(s):  
Veterans Affairs ◽  
Clinical Staff ◽  
Department Of Veterans Affairs ◽  
Care Needs ◽  
Multivariate Statistical ◽  
Work Related ◽  
Workforce Preparedness ◽  
Household Preparedness ◽  
The U.S ◽  
Relevant Factors

Objective: An infectious disease outbreak can place a significant burden on healthcare systems, however, our understanding of the broader healthcare workforce’s preparedness during a pandemic is limited. This study examines factors that influence perceived workforce preparedness at the U.S. Department of Veterans Affairs (VA) during a pandemic. Methods: The VA Preparedness Survey was a random, anonymous, web-based survey fielded nationwide October to December 2018. Multivariate statistical analyses examined the effects of study relevant factors (sociodemographic, work-related, general health, and household-related characteristics of VA employees) on perceptions of workforce preparedness, including institutional readiness and understanding of individual roles during a pandemic. Results: Four thousand and twenty-six VA employees responded. Overall, 55% were confident in their VA medical facility’s ability to respond; 49% understood their role; and 68% reported their role to be important during a pandemic. After controlling for study-relevant factors, household preparedness, having plans that address the health care needs of family members, and higher self-reported health status were associated with all 3 workforce preparedness variables. Clinical staff (compared to non-clinical staff) were less likely (OR:0.80, 95% CI:0.68-0.94, P < .01) to have confidence in their medical facility’s ability to respond but more likely (OR:1.77, 95% CI:1.49-2.10, P < .001) to believe their role was important. Employees who have been at the VA longer (OR:1.07, 95% CI:1.01-1.14, P < .05) or have experienced a disaster while working at the VA (OR:1.29, 95% CI:1.04-1.59, P < .05) were more likely to understand their role during a pandemic. Conclusion: The findings from this study suggest the need for identifying ways to increase VA employees’ confidence in their medical facility’s ability to respond to a pandemic; develop trainings to improve understanding of their different yet critical roles, for both clinical and non-clinical staff, during a pandemic; create different workforce trainings for newly hired employees; and identify ways to improve household preparedness for a pandemic outbreak.

Estimating Lost Revenue From a Free-Care Mandate in the U.S. Department of Veterans Affairs

2010 ◽  
Vol 61 (11) ◽  
pp. 1150-1152 ◽  
Author(s):  
Mark W. Smith ◽  
Adam Chow ◽  
Rachel Kimerling
Keyword(s):  
Veterans Affairs ◽  
Department Of Veterans Affairs ◽  
Free Care ◽  
The U.S
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