Creating and Implementing an Academic Detailing (AD) Program

Developed for the prescribing of opioids for pain management

doctor crossed hands

Our Goal

Our goal is to equip organizations looking to implement an academic detailing program(s) aimed to impact providers’ opioid prescribing and chronic pain management practices. These resources were developed and supported by the CDC grant no. R01CE003156-01

New Research: Academic Detailing’s Role in Combatting the Opioid Epidemic Heading link

preview of infographic

Our team created an infographic to summarize the findings of a study conducted in 2020 through 2022, which aimed to measure the effectiveness of academic detailing on opioid prescribing for Illinois healthcare providers. A preview of the infographic is shown to the left or you can download a full copy of the material by clicking here.

Toolkit Instructions Heading link

Welcome to your opioid use toolkit! Above you will find a video on how to use and interact with the toolkit to best suit your needs.

Educational Tools & Materials Heading link

Being well prepared and ready to engage with a prescriber during an academic detailing visit are two crucial aspects to providing a
substantive session. The right educational tools and materials will set you up to have the best lasting impact on a provider’s
prescribing practices, enhancing the way patients get cared for.

Below you will find a collection of informational brochures, resources, and handouts on how to navigate key programs that relate to
academic detailing for the purpose of opioid prescribing.

These informational brochures were developed by The University of Illinois College of Pharmacy (UIC COP) in collaboration with IL
ADVANCE with funding from the CDC to be used as an aid during detailing visits by academic detailers.

Opioid Alternatives

  • Click the link above for a PDF resource on alternative, evidence-based opioid-free pain management adapted from CDC
    guidelines. This information can be useful to treat opioid-naive patients or those hesitant to start an opioid.

CDC Guideline Overview On Opioid Prescribing

  • Click the link above for a PDF resource on opiate prescribing as it relates to chronic pain management, adapted from CDC
    guidelines. This resource can be a tool for healthcare providers to treat patients where opioid benefits outweigh their risks in
    which opioids are the superior option for the management of pain and function.

New features of the IL Prescription Monitoring Program (PMP)

  • Click the link above for a PDF resource on improvements and advancements made to the IL PMP. The IL PMP is a web-based
    record-keeping system used to better assess adherence and/or abuse by patients who are prescribed opioid medications for
    pain management.

Preventing Opioid Misuse and Abuse

  • Click the link above for a PDF resource on the prevention of opioid misuse and abuse, including how to manage opioid use
    disorder (OUD) and proper tapering methods.

Illinois Department of Public Health’s Real-Time Opioid Dashboard

IL ADVANCE  – Opioid Safety Resources

Alosa Health’s Opioid Management Resource

Sample of Illinois PMP’s Dashboard Metrics

Illinois Prescription Monitoring Program – Naloxone Brochure

List of Illinois Rehabilitation Facilities – Chicago (Cook County)

List of Illinois Rehabilitation Facilities – Chicago Suburbs (Collar Counties)

Creating an Academic Detailing (AD) Program Guidebook Heading link

Starting an Academic Detailing Program Guidebook

Based on our previous academic detailing work in Illinois and valuable lessons learned throughout the 3-year project period, our
team developed a manual to provide guidance for the successful development of an opioid-focused academic detailing (AD)
program. This guidebook will include materials related to establishing academic detailing program goals, developing of program
materials, utilizing general and state-specific academic detailing resources, and engagement strategies with relevant stakeholders.

Our goal is to equip organizations with practical and logistical considerations as they look to implement an academic detailing
program aimed to impact healthcare providers’ opioid prescribing and chronic pain management practices. While we use opioid
prescribing outcomes in our examples whenever possible, the overarching ideas in this guide can be applied to any clinician
education that utilizes academic detailing. We provide links to resources and other organizations’ materials as appropriate.

Detailing Visit Evaluation Tools Heading link

An academic detailing program is only as good as the results it provides. In order to best assess your program, the right metrics and data collection tools need to be in place to capture feedback from both the detailers and prescribers.

Provider Satisfaction of Academic Detailing (PSAD)

  • An instrument to capture provider satisfaction with an academic detailing visit. Given the importance of satisfaction as a process outcome, as well as a potential predictor of program effectiveness, PSAD was developed due to the need for a valid and reliable measure of provider satisfaction with AD visits.
  • If you work for an academic or non-profit institution, you may access the PSAD for free at the link above.
  • For all commercial uses, please contact UIC’s Office of Technology Management to request a copy of the survey.

Detailer Assessment of Visit Effectiveness (DAVE)

  • An instrument to capture the detailer’s assessment of the effectiveness of the visit. The goal of the entire AD process is for it to be effective for all parties involved. By using DAVE, organizations can learn first-hand from their detailers how the visit went and its potential benefits.
  • If you work for an academic or non-profit institution, you may access the DAVE for free at the link above.
  • For all commercial uses, please contact UIC’s Office of Technology Management to request a copy of the survey.

Detailer Fieldnote Template

This is an example of the questions we ask detailers to prompt important details from the academic detailing visit. While this is not meant to be exhaustive, it’s a good starting point to developing your own framework and eliciting the details from academic detailing visits you are most interested in capturing.

Program Testimonials Heading link

Academic detailers from IL ADVANCE shared their experiences in the video above.

Literature Related Resources Heading link

Below you will find a collection of published manuscripts, abstracts, presentations, and papers that helped form and resulted from this initiative.

Published Manuscripts

  1. Abd-Elsayed A, Albert CA, Fischer M, Anderson B. Naloxone academic detailing: role of community outreach teaching. Curr Pain Headache Rep. Aug 27 2018;22(11):72. doi:10.1007/s11916-018-0730-4
  2. Barth KS, Ball S, Adams RS, et al. Development and feasibility of an academic detailing intervention to improve prescription drug monitoring program Use Among Physicians. J Contin Educ Health Prof. Spring 2017;37(2):98-105. doi:10.1097/ceh.0000000000000149
  3. Behar E, Rowe C, Santos GM, Santos N, Coffin PO. Academic Detailing Pilot for Naloxone Prescribing Among Primary Care Providers in San Francisco. Fam Med. Feb 2017;49(2):122-126.
  4. Bounthavong M, Devine EB, Christopher MLD, Harvey MA, Veenstra DL, Basu A. Implementation evaluation of academic detailing on naloxone prescribing trends at the United States veterans health administration. Health Serv Res. Oct 2019;54(5):1055-1064. doi:10.1111/1475-6773.13194
  5. Bounthavong M, Harvey MA, Wells DL, et al. Trends in naloxone prescriptions prescribed after implementation of a national academic detailing service in the veterans health administration: A preliminary analysis. J Am Pharm Assoc (2003). Mar-Apr 2017;57(2s):S68-s72. doi:10.1016/j.japh.2016.11.003
  6. Clark B, Kai M, Dix R, et al. Association of a multimodal educational intervention for primary care physicians with prescriptions of buprenorphine for opioid use disorders. JAMA Netw Open. Oct 2 2019;2(10):e1913818. doi:10.1001/jamanetworkopen.2019.13818
  7. Cochella S, Bateman K. Provider detailing: an intervention to decrease prescription opioid deaths in Utah. Pain Med. Jun 2011;12 Suppl 2:S73-6. doi:10.1111/j.1526-4637.2011.01125.x
  8. Dieujuste N, Johnson-Koenke R, Christopher M, et al. Feasibility study of a quasi-experimental regional opioid safety prescribing program in veterans health administration emergency departments. Acad Emerg Med. Aug 2020;27(8):734-741. doi:10.1111/acem.13980
  9. Donaldson SR, Harding AM, Taylor SE, Vally H, Greene SL. Evaluation of a targeted prescriber education intervention on emergency department discharge oxycodone prescribing. Emerg Med Australas. Aug 2017;29(4):400-406. doi:10.1111/1742-6723.12772
  10. Evoy KE, Groff L, Hill LG, Godinez W, Gandhi R, Reveles KR. Impact of student pharmacist-led naloxone academic detailing at community pharmacies in Texas. J Am Pharm Assoc (2003). Jan-Feb 2020;60(1):81-86. doi:10.1016/j.japh.2019.09.007
  11. Kattan JA, Tuazon E, Paone D, et al. Public health detailing-A successful strategy to promote judicious opioid analgesic prescribing. Am J Public Health. Aug 2016;106(8):1430-8. doi:10.2105/ajph.2016.303274
  12. Larson MJ, Browne C, Nikitin RV, et al. Physicians report adopting safer opioid prescribing behaviors after academic detailing intervention. Subst Abus. 2018;39(2):218-224. doi:10.1080/08897077.2018.1449175
  13. Lasser KE, Shanahan C, Parker V, et al. A multicomponent intervention to improve primary care provider adherence to chronic opioid therapy guidelines and reduce opioid misuse: A Cluster Randomized Controlled Trial Protocol. J Subst Abuse Treat. Jan 2016;60:101-9. doi:10.1016/j.jsat.2015.06.018
  14. Liebschutz JM, Xuan Z, Shanahan CW, et al. Improving adherence to long-term opioid therapy guidelines to reduce opioid misuse in primary care: A Cluster-Randomized Clinical Trial. JAMA Intern Med. Sep 1 2017;177(9):1265-1272. doi:10.1001/jamainternmed.2017.2468
  15. Lira MC, Tsui JI, Liebschutz JM, et al. Study protocol for the targeting effective analgesia in clinics for HIV (TEACH) study – a cluster randomized controlled trial and parallel cohort to increase guideline concordant care for long-term opioid therapy among people living with HIV. HIV Res Clin Pract. Apr 2019;20(2):48-63. doi:10.1080/15284336.2019.1627509
  16. May F, Simpson D, Hart L, Rowett D, Perrier D. Experience with academic detailing services for quality improvement in primary care practice. Qual Saf Health Care. Jun 2009;18(3):225-31. doi:10.1136/qshc.2006.021956
  17. Midboe AM, Wu J, Erhardt T, et al. Academic detailing to improve opioid safety: Implementation lessons from a qualitative evaluation. Pain Med. Sep 1 2018;19(suppl_1):S46-s53. doi:10.1093/pm/pny085
  18. Quanbeck A, Brown RT, Zgierska AE, et al. A randomized matched-pairs study of feasibility, acceptability, and effectiveness of systems consultation: a novel implementation strategy for adopting clinical guidelines for Opioid prescribing in primary care. Implement Sci. Jan 25 2018;13(1):21. doi:10.1186/s13012-018-0713-1
  19. Saffore CD, Pickard AS, Crawford SY, Fischer MA, Sharp LK, Lee TA. Practice change intentions after academic detailing align with subsequent opioid prescribing. J Am Pharm Assoc (2003). Nov-Dec 2020;60(6):1001-1008. doi:10.1016/j.japh.2020.08.011
  20. Saffore CD, Tilton ST, Crawford SY, et al. Identification of barriers to safe opioid prescribing in primary care: a qualitative analysis of field notes collected through academic detailing. Br J Gen Pract. Aug 2020;70(697):e589-e597. doi:10.3399/bjgp20X711737
  21. Samet JH, Tsui JI, Cheng DM, et al. Improving the delivery of chronic opioid therapy among people living with HIV: A Cluster Randomized Clinical Trial. Clin Infect Dis. Jul 22 2020;doi:10.1093/cid/ciaa1025
  22. Shaw J, Harris P, Keogh G, Graudins L, Perks E, Thomas PS. Error reduction: academic detailing as a method to reduce incorrect prescriptions. Eur J Clin Pharmacol. Nov 2003;59(8-9):697-9. doi:10.1007/s00228-003-0683-2
  23. Smart MH, Mandava MR, Lee TA, Pickard AS. Feasibility and acceptability of virtual academic detailing on opioid prescribing. Int J Med Inform. Mar 2021;147:104365. doi:10.1016/j.ijmedinf.2020.104365
  24. Stevens J, Trimboli A, Samios P, et al. A sustainable method to reduce postoperative oxycodone discharge prescribing in a metropolitan tertiary referral hospital. Anaesthesia. Mar 2019;74(3):292-299. doi:10.1111/anae.14570
  25. Voelker KA, Schauberger C. Academic detailing for postpartum opioid prescribing. J Am Board Fam Med. 2018;31(6):944-946. doi:10.3122/jabfm.2018.06.180071

List of Published Abstracts

  1. Monteiro A, Smart M, Saffore C, Lee TA, Fischer MA, Pickard AS. Development of a measure of prescriber satisfaction with academic detailing. Value Health. 2019;22(suppl 2):S260. International Society for Pharmacoeconomics and Outcomes abstract PMU60.
  2. Smart M, Monteiro A, Saffore C, et al. Initial development of an instrument to assess the effectiveness of academic detailing visits. Value Health. 2019;22(suppl 2):S309. International Society for Pharmacoeconomics and Outcomes abstract PNS142.
  3. Monteiro A, Saffore CD, Smart M, Tilton S, Lee TA, Pickard AS. Development of an instrument to assess prescriber’s satisfaction with an academic detailing intervention. Innov Pharm. 2018;9(3). Midwest Social and Administrative Pharmacy abstract article 5.

Presentations

  1. Lee TA. Effectiveness of academic detailing on opioid prescribing in primary care Oral presentation presented at: UIC College of Pharmacy Department of Pharmacy Systems Outcomes and Policy Spring 2020 Seminar; April 2, 2020; Chicago, IL.
  2. Tilton ST, Sharp LK, Saffore CD, Smart M, Lee TA, Pickard AS. A thematic analysis of barriers to appropriate opioid and non-opioid pain management by primary care providers. Poster presented at: 10th Annual UIC College of Pharmacy Research Day; February 8, 2019; Chicago, IL.
  3. Ruseva A, Smart M, Monteiro A, et al. Psychometric properties of a measure to assess effectiveness of academic detailing visits. Poster presented at: 10th Annual UIC College of Pharmacy Research Day; February 8, 2019; Chicago, IL.
  4. Lee T, Pickard AS, Saffore C. Tailored approaches to opioid-related academic detailing of urban and rural prescribers. Oral presentation presented at: 2019 Rx Drug Abuse & Heroin Summit; April 24, 2019; Atlanta, GA.
  5. Saffore CD. Addressing barriers to academic detailing in urban and rural settings: lessons learned. Oral presentation presented at: 2019 Rx Drug Abuse & Heroin Summit; April 24, 2019; Atlanta, GA.
  6. Monteiro A, Smart M, Saffore CD, Lee TA, Pickard AS. Development of an instrument to assess prescriber’s satisfaction with an academic detailing intervention. Poster presented at: ISPOR 24th Annual International Meeting; May 19, 2019; New Orleans, LA.
  7. Saffore CD, Monteiro A, Smart M, Lee TA, Pickard AS. Development of an instrument to assess academic detailer’s experience with academic detailing visits. Poster presented at: ISPOR 24th Annual International Meeting; May 19, 2019; New Orleans, LA.
  8. Pickard SA, Lee TA. Impact of academic detailing in the Chicagoland region: a pilot study. Oral presentation presented at: Illinois Prescription Monitoring Program Advisory Committee Meeting; March 21, 2018; Chicago, IL.
  9. Lee TA. Prescription drug monitoring program and academic detailing. Oral presentation presented at: Rockford Opioid Summit; April 11, 2018; Rockford, IL.
  10. Ruseva A, Smart M, Saffore CD, Lee TA, Pickard AS. Pre-development of a measure of perceived effectiveness of an academic detailing visit to improve safe and appropriate opioid prescribing: identification of themes. Poster presented at: SURF/Riback Mini Symposium; August 2, 2018; Chicago, IL.
  11. Tilton S, Sharp LK, Saffore CD, Smart M, Lee TA, Pickard AS. Identifying themes related to assessing prescriber’s satisfaction with an academic detailing intervention. Poster presented at: SURF/Riback Mini Symposium; August 2, 2018; Chicago, IL.
  12. Saffore CD, Monteiro A, Smart M, Ruseva A, Pickard AS, Lee TA. Development of an instrument to assess academic detailer’s experience with academic detailing visits. Oral presentation presented at: 18th Midwest Social and Administrative Pharmacy Conference; August 16, 2018; Madison, WI.
  13. Monteiro A, Saffore CD, Smart M, Tilton S, Lee TA, Pickard AS. Development of a measure of prescriber satisfaction with academic detailing. Oral presentation presented at: 18th Midwest Social and Administrative Pharmacy Conference; August 16, 2018; Madison, WI.
  14. Lee TA, Pickard AS. Identifying and improving opioid-related prescribing. Oral presentation presented at: UIC East + West Research Mixer; September 6th, 2018; Chicago, IL.
  15. Pickard AS. Detailing without borders: the virtual detailing approach. Oral presentation presented at: NaRCAD 2019 7th International Conference on Academic Detailing: “Collaboration for Clinical Change”; November 7, 2019; Boston, MA.
  16. Saffore CD. Identification of barriers to opioid prescribing through AD. Oral presentation presented at: NaRCAD 2019 7th International Conference on Academic Detailing: “Collaboration for Clinical Change”; November 8, 2019; Boston, MA.
  1. Volkow ND, Frieden TR, Hyde PS, Cha SS. Medication-assisted therapies–tackling the opioid-overdose epidemic. N Engl J Med. 2014;370(22):2063-2066. doi: 10.1056/NEJMp1402780
  2. Wakeman SE, Larochelle MR, Ameli O, et al. Comparative effectiveness of different treatment pathways for opioid use disorder. JAMA Netw Open. 2020;3(2):e1920622. doi: 10.1001/jamanetworkopen.2019.20622
  3. Robinson A, Christensen A, Bacon S. From the CDC: the Prevention for States program: preventing opioid overdose through evidence-based intervention and innovation. J Safety Res. 2019;68:231-237. doi: 10.1016/j.jsr.2018.10.011
  4. Krebs EE, Gravely A, Nugent S, et al. Effect of opioid vs nonopioid medications on pain-related function in patients with chronic back pain or hip or knee osteoarthritis pain: the SPACE randomized clinical trial. JAMA. 2018;319(9):872-882. doi: 10.1001/jama.2018.0899
  5. Chang AK, Bijur PE, Esses D, Barnaby DP, Baer J. Effect of a single dose of oral opioid and nonopioid analgesics on acute extremity pain in the emergency department: a randomized clinical trial. JAMA. 2017;318(17):1661-1667. doi: 10.1001/jama.2017.16190
  6. Schwartz RP, Gryczynski J, O’Grady KE, et al. Opioid agonist treatments and heroin overdose deaths in Baltimore, Maryland, 1995-2009. Am J Public Health. 2013;103(5):917-922. doi: 10.2105/AJPH.2012.301049
  7. Liebschutz JM, Xuan Z, Shanahan CW, et al. Improving adherence to long-term opioid therapy guidelines to reduce opioid misuse in primary care: a cluster-randomized clinical trial. JAMA Intern Med. 2017;177(9):1265-1272. doi: 10.1001/jamainternmed.2017.2468
  8. Bounthavong M, Harvey MA, Wells DL, et al. Trends in naloxone prescriptions prescribed after implementation of a National Academic Detailing Service in the Veterans Health Administration: a preliminary analysis. J Am Pharm Assoc (2003). 2017;57(2S):S68-S72. doi: 10.1016/j.japh.2016.11.003
  9. Guy GP Jr, Zhang K, Bohm MK, et al. Vital signs: changes in opioid prescribing in the United States, 2006-2015. MMWR Morb Mortal Wkly Rep. 2017;66(26):697-704. doi: 10.15585/mmwr.mm6626a4

Other Resources Heading link

National Resource Center for Academic Detailing (NaRCAD)

The Centers for Disease Control and Prevention (CDC)

UIC-Based Continuing Medical Education Credit (CME) Opportunities

The American Society of Anesthesiologists™ Pain Alleviation Toolkit

The Veterans Affairs Academic Detailing Service: Pain & Opioid Safety Initiative

JAMA Opioid Research Archives

Epi Data Brief Overdose Resource

Community Catalyst Resources