Enhancing Naloxone Distribution and Academic Detailing Effectiveness: Insights From an Online Priority Panel Report at the United States Veterans Health Administration

ABSTRACT Introduction In 2017, the United States Department of Veterans Affairs (VA) Pharmacy Benefits Management Academic Detailing Services implemented an online dashboard called the Priority Panel Report (PPR) to identify clinicians with a large number of veterans at risk for opioid overdose/death for naloxone‐related educational outreach to improve naloxone prescribing at the VA. Objectives The primary objective was to evaluate the impact of the PPR on naloxone prescribing rate. The secondary objective evaluated the effectiveness of academic detailing (AD) on naloxone prescribing rate after clinicians were added to the PPR. Methods An interrupted time series analysis was conducted to compare the differences in naloxone prescribing rate (per 1000 patients) 12 months before and after clinicians were added to the PPR (index period) at the VA. Clinicians who were actively prescribing 12 months before and after the index period were included for analysis between October 1, 2017, and July 1, 2021. Clinicians who received naloxone‐related AD before the index period were excluded. The naloxone prescribing rate was calculated as the number of naloxone prescriptions ordered divided by the total number of veterans who are at risk of an opioid‐related overdose or death. Results Immediately after the index period, the average naloxone prescribing rate increased by 4.29 prescriptions per 1000 patients (95% confidence interval [CI]: 2.90, 5.68). After the index period, the average monthly naloxone prescribing rate was significantly greater than before by 0.63 prescriptions per 1000 patients (95% CI: 0.38, 0.88). Clinicians who received AD had significantly greater monthly naloxone prescribing rate than clinicians who did not between 0 and 7 months after the index period. No differences in monthly naloxone prescribing rate were detected ≥ 8 months after the index period. Conclusion The PPR was associated with increased naloxone prescribing rate and enhanced AD effectiveness. However, further studies will need to identify other factors for long‐term sustainability of AD impact.