Proposal%20for%20Supporting%20Academic%20Detailing%20on%20Safe%20Pain%20Medication%20Use%20for%20Utah%20Providers

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Proposal for Supporting Academic Detailing
onSafe Pain Medication Use for Utah Providers
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Focus is on Provider Education

• Nearly ½ of deaths had valid Rx
• Half of these involved methadone
• Large number also on benzodiazepines
• Patients and families often didnt recognize
  developing problem

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Challenges

• Reduce deaths but preserve indicated Rx
• Engage time-pressured providers
• Displace current practices and mental models
• Requires mindful approach
• Overcome skepticism
• Confounding issues (mental health, addiction,
  diversion)

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Approach

• Interactive face-to-face learning
• Support materials
• Practice redesign
• Performance feedback
• Enhanced by
• Using existing relationships
• Reputable sources if information
• Demonstrating respect for targeted providers

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Intervention Methods DetailBalance effectiveness
with cost efficiency

• 10 rural and 20 Wasatch front groups
• Educational presentation
• Tools and support materials
• Practice redesign
• Performance feedback
• Large audience CME (6-10 meetings)
• Partner with Intermountain and U. of U. Clinics
• Articles

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Recruitment

• Use regularly scheduled meetings
• Customized mail, email, and telephone invitations
• Instructions to look at DOPL Controlled
  Substances Database ahead of time.

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Materials to provide attendees

• Comparison data
• Guidelines
• Toolbox
• Patient education forms
• Referral options for addicts, mentally ill,
  inadequate pain response
• Information for HealthInsight assistance
• Access to peer experts

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Areas of primary focus

• Screening patients for risk vs. benefit from
  long-acting narcotics
• Understanding special issues with methadone
• Avoiding benzodiazepines in combination with
  opioids
• Use of sleep studies when appropriate
• Avoiding long-acting opioids for acute pain
• Educating patients and families regarding risks
  and signs of toxicity

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Areas of secondary focus

• Dealing with drug-seeking patients
• Dealing with diversion
• Preferred approaches to non-malignant pain

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Supplemental education strategies

• Intermountain
• University of Utah clinics
• UMIA
• Physician meetings
• Articles

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Measurement and evaluation

• PPMEP steering committee
• Patient outcomes
• HealthInsight
• Process measures
• Number, percent reached by specialty
• Provider evaluations of sessions
• Follow-up calls to track process changes

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SummaryOver next 12 months

• 10 rural small group meetings
• 20 Wasatch front small group meetings
• Integrate with Intermountain, U. of Utah, UMIA
• Several statewide CME meetings
• Articles in UMA Bulletin