Academic detailing: Using clinical evidence to improve care

2013 ◽  
Vol 2 (12) ◽  
pp. 392-394 ◽  
Author(s):  
Sarah J. Popish
Keyword(s):  
Clinical Evidence ◽  
Educational Outreach ◽  
Evidence Based ◽  
Therapeutic Area ◽  
Academic Detailing ◽  
Prescribing Practices ◽  
Evidence Based Treatment ◽  
Outreach Service ◽  
The Impact

Academic detailing is an educational outreach service that is effective at promoting evidence-based treatment for a given therapeutic area. This article describes what academic detailing entails, and reviews the findings of studies on the impact of academic detailing on prescribing practices.

scholarly journals Evaluating the Impact of Training Health Professionals to Deliver Brief Motivational and Skills-Based Interventions for Cannabis Use Disorder

2012 ◽  
Vol 2 ◽  
Author(s):  
Dion Alperstein ◽  
Jan Copeland
Keyword(s):  
Clinical Training ◽  
Health Workers ◽  
Clinical Skills ◽  
Cannabis Use ◽  
Evidence Based ◽  
Transfer Of Knowledge ◽  
Evidence Based Treatment ◽  
Cognitive Behavioural ◽  
The Impact

Background: While there is considerable evidence that brief motivational and skills-based interventions for substance use are effective, little is known regarding the transfer of knowledge from research to practice. This study aims to evaluate the effectiveness of two half-day didactic clinical training workshops for allied health workers, which did not incorporate feedback or supervision, via independent follow-up three months post training.Methods: In total, 1322 participants attended either or both of the evidence-based treatment workshops run by the National Cannabis Prevention and Information Centre. Of those participants, 495 (37%) completed an online follow-up evaluation three months later regarding their use of the newly learnt intervention(s).Results: At follow-up, 270 (54.5%) participants had an opportunity to use the skills and 144 (53.3%) of those participants reported having used the clinical skills taught in the workshop. Of those who used one of the interventions, 90 (62.5%) participants reported their clients had reduced or quit their cannabis use. Furthermore, 43 (30%) of these participants had attempted to train others in the workplace in the techniques learnt in the workshop.Conclusion: Even a half-day didactic clinical training workshop on evidence-based brief cognitive–behavioural techniques delivered to clinicians working in the field can improve knowledge and confidence among clinicians and outcomes among their clients with cannabis use related problems.

scholarly journals “Turning the tide” in Treatment of substance use: A nursing response

2017 ◽  
Vol 8 (2) ◽  
pp. 116 ◽  
Author(s):  
Julie Worley ◽  
Kathleen R. Delaney
Keyword(s):  
Substance Use ◽  
Healthcare Provider ◽  
Substance Use Disorders ◽  
Evidence Based ◽  
Review Of Literature ◽  
Evidence Based Treatment ◽  
The Impact

Objective: To analyze science and practice surrounding nursing approaches to substance use disorders (SUDs) and make recommendations for the future.Methods: A review of literature and topics related to healthcare provider stigma, science surrounding SUDs, nursing approaches to SUDs in education and practice and evidence based treatment was conducted, analyzed and synthesized.Results: Stigma is embedded in nursing approach to SUDs, up to date information regarding SUDs is not widely disseminated or practiced in nursing.Conclusions: To reduce the impact of stigma and to bring nurses into the “turning the Tide” movement requires an understanding of how beliefs root stigma, building knowledge related to SUDs as an illness, and expansion of nurses' skill when intervening with individuals dealing with SUDs.

Academic Detailing to Reduce Sedative-Hypnotic Prescribing in Older Veterans

2019 ◽  
pp. 089719001987094 ◽  
Author(s):  
Addison P. Ragan ◽  
Garrett B. Aikens ◽  
Mark Bounthavong ◽  
Kevin Brittain ◽  
Anna Mirk
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Benzodiazepine Receptor ◽  
Educational Outreach ◽  
Potentially Inappropriate Medications ◽  
Veterans Health ◽  
Academic Detailing ◽  
Health Administration ◽  
Prescribing Trends ◽  
The Impact

Background: Sedative-hypnotics, including benzodiazepines (BZDs) and benzodiazepine receptor agonists (BZD-RA), are considered potentially inappropriate medications (PIMs) in older adults. Academic detailing, an educational outreach delivered by trained clinicians to other clinicians to encourage evidence-based care, can promote deprescribing of PIMs. Objective: To evaluate the impact of academic detailing on sedative-hypnotic prescribing to older veterans. Methods: A retrospective analysis was performed to evaluate the impact of academic detailing on BZD and BZD-RA prescribing to veterans aged 75 years and older. Prescribing trends for primary care and mental health prescribers in the Veterans Health Administration (VA) Southeast Network were calculated for the 18 months before and after an initial academic detailing session for each prescriber. Pre–post interrupted time series analyses (ITSAs) were conducted, and period prevalence was calculated as the number of prescriptions per 1000 older veterans. Results: A total of 155 prescribers were followed for 36 months. BZD prevalence declined by 23% (69.08-53.33 per 1000 population; P < .001) and by 15% for BZD-RA (18.07-15.38 per 1000 population; P < .001). New starts on BZD declined by 54% (2.36-1.09 per 1000 population; P < .001) and new starts on BZD-RA declined by 53% (1.02-0.48 per 1000 population; P < .001). Alternative medications for insomnia increased by 23% (39.98-49.27 per 1000 population; P < .001). Findings from the ITSA confirmed those of the pre–post analysis with sustained effects in the postintervention period. Conclusions: Academic detailing was associated with reduced sedative-hypnotic prescribing in the primary care and mental health setting.

scholarly journals Five-year follow-up of an evidence-based prescribing intervention

2008 ◽  
Vol 32 (5) ◽  
pp. 183-186 ◽  
Author(s):  
David Meagher ◽  
Ananth Pullela ◽  
Marek Meisinger ◽  
Niamh Geaney ◽  
Sinead O'Brien
Keyword(s):  
Clinical Implications ◽  
High Dose ◽  
Evidence Based ◽  
Community Mental Health Service ◽  
Prescribing Practices ◽  
Multidisciplinary Intervention ◽  
Prescribing Practice ◽  
Multifaceted Interventions ◽  
The Impact

Aims and MethodWe studied the impact of an evidence-based multidisciplinary intervention to reduce six sub-optimal aspects of psychotropic prescribing, combined as a Prescribing Practice Quality (PPQ) score over a 5-year follow-up period in a community mental health service.ResultsSub-optimal prescribing practices were significantly reduced after 1 year and these improvements were sustained at 5-year follow-up. The PPQ scores were significantly reduced (P<0.001) in both the overall population attending at each follow-up point as well as in the ever-present population (n=163). Use of high-dose antipsychotics and thioridazine ceased entirely; use of sedative hypnotic agents was less amenable to reduction.Clinical ImplicationsMultifaceted interventions can achieve sustained improvements in prescribing practices in real-world settings.

Clinician-Reported Modification to a CBT Approach in Children’s Mental Health

2019 ◽  
Vol 28 (2) ◽  
pp. 104-113 ◽  
Author(s):  
Rosemary D. Meza ◽  
Nathaniel Jungbluth ◽  
Georganna Sedlar ◽  
Prerna Martin ◽  
Lucy Berliner ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Behavioral Therapy ◽  
Children And Adolescents ◽  
Behavioral Therapy ◽  
Evidence Based ◽  
Implementation Climate ◽  
Evidence Based Treatment ◽  
Training Post ◽  
The Impact ◽  
Client Needs

Examining the nature and determinants of evidence-based treatment (EBT) modification is an important step toward understanding the impact of modifications and informing modification guidelines. We examined the prevalence, types, reasons for, and predictors of clinician-reported modification to cognitive behavioral therapy (CBT) for children and adolescents. Ninety-eight clinicians trained in CBT completed surveys on their intent to modify CBT, perceptions of CBT characteristics, confidence in their ability to appropriately deliver CBT in complex clinical situations, and organizational EBT implementation climate post-training. Post-consultation, clinicians self-reported the types and reasons for modifications they performed. Ninety-three percent of clinicians reported they modified CBT, primarily with fewer than half of their clients. Client needs and clinician preference or style accounted for the highest proportion of modification reasons. The number of reported modifications performed was predicted by clinician confidence in their ability to deliver CBT appropriately ( b = .90, p = .01) and their intent to modify ( b = .55, p = .01).

Creating an Opioid Recommendation Card for Trainees: Methods, Use, and Impact

2020 ◽  
pp. 000313482094062
Author(s):  
Mollie R. Freedman-Weiss ◽  
Alexander S. Chiu ◽  
Erin M. White ◽  
Peter S. Yoo
Keyword(s):  
Postoperative Analgesia ◽  
Opioid Analgesic ◽  
Junior Resident ◽  
Evidence Based ◽  
Prescribing Practices ◽  
Opioid Prescribing ◽  
Surgical Residents ◽  
Surgical Trainees ◽  
Wide Variability ◽  
The Impact

Background In academic hospitals, surgical residents write most of the postoperative prescriptions; yet, few residents are trained on postoperative analgesia. This leads to wide variability in practices and often excess opioid prescribing. We sought to create an opioid guideline pocket card for surgical residents to access when prescribing opioids postoperatively and to evaluate the impact of this initiative. Methods A comprehensive literature review was conducted to generate evidence-based procedure-specific opioid recommendations; additional recommendations were formulated via consensus opinion from surgical divisions at an academic institution. A pocket-sized guideline card was developed to include these procedure-specific recommendations as well as opioid guidelines for discharges after inpatient stays, non-opioid analgesic recommendations, access to opioid safety and disposal instructions for patients discharge, an equianalgesic dosing chart, and instructions for naloxone use. The card was distributed to all General Surgery house staff at a university-affiliated hospital in the spring of 2018. Following the distribution, trainees were surveyed on their use of the card. Descriptive statistics were used to analyze the survey. Results Of 85 trainees, 62 (72.9%) responded to the survey in full; 58% use the card regularly. Of the 27 junior resident respondents, 70.4% use the card at least monthly including 48.1% who use the card daily-to-weekly. Overall, 81.6% of residents changed their opioid-prescribing practices because of this initiative and 89.8% believe the card should continue to be distributed and used. Discussion An evidence-based guideline card for postoperative analgesia is highly valued and utilized by surgical trainees, especially those most junior in their training.

Evidence-based treatment of mania

2017 ◽  
Author(s):  
Bernardo Ng ◽  
Mauricio Tohen
Keyword(s):  
Atypical Antipsychotics ◽  
Clinical Evidence ◽  
Treatment Options ◽  
Evidence Based ◽  
Psychiatric Condition ◽  
Evidence Based Treatment ◽  
Psychiatric Illnesses ◽  
Pregnancy And Lactation ◽  
Individualize Treatment ◽  
Psychopharmacological Agents

Bipolar mania can be one of the most challenging psychiatric illnesses to treat, as it requires the clinician to make rapid and accurate decisions; have a reliable way of evaluating progress and treatment response; and possess keen psychotherapeutic skills. Therefore, the importance of staying updated on the clinical evidence of the various treatment options, which serves as the basis to individualize treatment on the day-to-day progress or deterioration of the manic patient. This chapter presents a review available on the evidence of different psychopharmacological agents including typical antipsychotics, lithium, antiepileptic drugs and atypical antipsychotics, and FDA-approved dosages. This review also includes these agents’ effects on fertility and recommendations about their use during pregnancy and lactation. Bipolar disorder continues to be a complex psychiatric condition, yet the progress in treatment options for the manic phase has evolved such that we have more options than ever before.

Influencing antiemetic prescribing practices and funding changes through evidence-based guidelines.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 31-31
Author(s):  
Kathy Vu ◽  
Michael Wan ◽  
Aliya Pardhan ◽  
Erin Redwood ◽  
Andrea Crespo ◽  
...  
Keyword(s):  
Public Funding ◽  
Drug Benefit ◽  
Evidence Based ◽  
Drug Formulary ◽  
Prescribing Practices ◽  
Receptor Antagonists ◽  
Line Therapy ◽  
Evidence Based Guidelines ◽  
The Impact ◽  
Made In

31 Background: In 2013 Cancer Care Ontario released updated antiemetic recommendations supporting the use of aprepitant-based combinations as 1st line therapy for highly emetogenic and 2nd line therapy for moderately emetogenic chemotherapy and discouraging the prolonged use of 5-HT3 antagonists. In 2014 changes were made in the Ontario drug formulary to align public funding to those recommendations. The impact of the changes in guidance and public funding on prescribing practices are now being analyzed. Methods: Using the Ontario Drug Benefit (ODB) database, data was extracted to analyze the prescribing practices of aprepitant, granisetron and ondansetron for chemotherapy-induced emesis between the pre-funding period (November 2013 to September 2014) and post-funding period (October 2014 to July 2015). Results: Prior to funding changes, an average of 197 prescriptions/month of aprepitant were billed to the ODB program totaling $22,422. After funding, an average of 1,165 prescriptions/month of aprepitant were billed totaling $132,145. This represented a 490% increase in utilization. The combined 5-HT3 receptor antagonists prescriptions/month billed during the respective time periods were 5,592 ($405,604) and 5,536 ($402,628). This represented a 1% decrease in utilization. Conclusions: There was a significant increase in aprepitant utilization and total expenditure to the ODB program indicating strong uptake of the triple-drug recommendation for highly emetogenic regimens. However, there was minimal change in prescribing practices related to the 5-HT3 receptor antagonists, indicating a reluctance to decrease utilization. Further work is necessary to discourage the prolonged use of 5-HT3 receptor antagonists.

Sign in / Sign up

Export Citation Format

Share Document