Utilizing Academic Detailing Intervention to Increase Screening, Referral, and Treatment for Opioid Use Disorder Among Primary Care Providers in Randolph County

Background: Opioid use disorder is a national epidemic that has killed over one million United States residents since 1999. Randolph County, North Carolina (NC) has a significantly higher rate of drug overdose and emergency-department-related visits than the NC state average. Primary care providers are well positioned to intervene and offer screening, referral, and treatment of opioid use disorder, yet this does not often occur.

Objective: This quality improvement project serves as a pilot to evaluate the effectiveness of academic detailing (AD) to increase screening, referral, and treatment of opioid use disorder as well as to increase knowledge of community resources available.

Methods: Face-to-face one-to-one AD was provided to primary care providers. Content included an overview of the diagnosis, standardized screening tools, management, and community resources available for referral. Assessments pre and post were conducted to evaluate screening, referral and treatment practices, knowledge of available community resources, barriers to providing services, and satisfaction with the AD event.

Results: AD did not result in change in frequency of screening or referral for treatment for OUD. None of the providers who participated in the intervention were prescribing buprenorphine prior to the event, nor were they after the event. Results indicated that there was an increase in the knowledge level of providers after AD with a change in median knowledge level from "I know about some resources in the area" to "I am very knowledgeable about area resources." Barriers to screening, referral, and treatment were identified, with lack of time being the most frequently cited.

Conclusions: AD did not increase screening, referral, or treatment of OUD in this pilot project. However, there was an increase in knowledge of community resources related to OUD. AD is labor and time intensive and may be difficult to scale.

Implications for nursing: Providers are well positioned to impact patient lives and increase screening, referral, and treatment for OUD in primary care settings. Continued work is needed to overcome barriers for getting patients adequate OUD treatment. Additional research is needed to ascertain if varied forms of AD would be more time and cost effective.