• Res Social Adm Pharm · Aug 2020

    Providers' perceptions on barriers and facilitators to prescribing naloxone for patients at risk for opioid overdose after implementation of a national academic detailing program: A qualitative assessment.

    • Mark Bounthavong, Kangho Suh, ChristopherMelissa L DMLDNational Academic Detailing Service, Pharmacy Benefits Management, U.S. Department of Veterans Affairs, Washington, D.C, USA., David L Veenstra, Anirban Basu, and Emily Beth Devine.
    • The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, Seattle, WA, USA; National Academic Detailing Service, Pharmacy Benefits Management, U.S. Department of Veterans Affairs, Washington, D.C, USA; Veterans Affairs (VA) Health Economics Resource Center (HERC), Menlo Park, CA, USA; Veterans Affairs (VA) Center for Innovation to Implementation (Ci2i), Menlo Park, CA, USA. Electronic address: mbounth@uw.edu.
    • Res Social Adm Pharm. 2020 Aug 1; 16 (8): 1033-1040.

    BackgroundAcademic detailing is an educational outreach program that aligns providers' prescribing with evidence-based practice. The U.S. Department of Veterans Affairs (VA) Opioid Overdose Education and Naloxone Distribution (OEND) Program partnered with the VA Pharmacy Benefits Management National Academic Detailing Service to deliver naloxone education to providers who cared for patients at risk of opioid overdose. In this pilot study, we interviewed providers' who received academic detailing to capture their perceptions of facilitators and barriers to prescribing naloxone.ObjectiveTo identify providers' perceptions of facilitators and barriers to prescribing naloxone for patients at risk for opioid overdose after implementation of a national academic detailing program.MethodsThis was a hybrid inductive-deductive qualitative pilot using semi-structured interviews with VA providers to explore constructs associated with facilitators and barriers to prescribing take-home naloxone to patients at risk for opioid overdose from August 2017 to April 2018.ResultsEleven participants were interviewed, six physicians, three clinical psychiatric pharmacists, and two nurse practitioners. Participants identified patient-level barriers (social stigma and lack of homeless patient support), poor data integration, and burden of data validation as barriers to prescribing naloxone. However, they also identified patient lists, repeat visits, and face-to-face/one-on-one video conferencing visits as important facilitators for naloxone prescribing.Conclusions/ImportanceAcademic detailing will need to address issues of social stigma regarding naloxone, educate providers about existing support systems for homeless veterans, and develop tools for data integration to improve naloxone access for veterans at risk for an opioid overdose.Published by Elsevier Inc.

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