Introduction

Social distancing requirements during COVID-19 pose a challenge to conducting traditional academic detailing, which typically involves in-person peer education visits to improve patient outcomes. The main alternative is to conduct virtual academic detailing delivered through web-based technology, but this approach is fraught with many challenges. This study aimed to examine the feasibility and acceptability of a virtual academic detailing program implemented among health care providers.

Methods

The academic detailing program focused on appropriate opioid prescribing and chronic non-cancer pain management among a sample of providers. An initial in-person visit was followed by a virtual visit up to 8 weeks later. Videoconferencing was used to conduct the virtual visit with telephone as a backup. Feasibility was assessed whether the virtual visits could happen, and acceptability was assessed by provider satisfaction. Validated measures of Provider Satisfaction with Academic Detailing (PSAD) and Detailer Assessment of Visit Effectiveness (DAVE) with a 5-point Likert-type scale were used. Higher scores corresponded to higher satisfaction and greater perceived effectiveness. Non-parametric and parametric statistical tests were used to compare instrument summary scores across visits and between groups. Pairwise analyses across visits only included instrument responses for providers who participated in both visits and completed both surveys in their entirety.

Results

There were 127 (90 %) initial in-person visits completed out of 141 visits scheduled, with a survey response rate of 96 %. Out of 120 virtual follow-up visits scheduled, 92 (77 %) were conducted, and 56 surveys (61 %) were collected. There was a high level of satisfaction with the initial and follow up virtual academic detailing visits, though, among providers who participated in both visits and had completed surveys (n = 50), initial visits had slightly higher scores (mean difference = −2.94 [95 % Confidence intervals: −4.38, −1.50], p < 0.001). There was no significant difference in detailer perception across the two visits as seen in the scale summary score (0.05 [−0.56, 0.66], p = 0.86) and two individually reported items related to feasibility (0.07 [−0.29, 0.42], p = 0.72) and conversation (−0.05 [−0.28, 0.17], p = 0.63). Forty-one (44.6 %) virtual visits were conducted using WebEx, where video and screen sharing of visit content was possible, while the remaining 51 (55.4 %) were conducted using a telephone. There was no significant difference in provider satisfaction between WebEx vs. telephone visits (-1.47 [-4.99, 2.05], p = 0.82). Provider satisfaction was also not impacted by any technical difficulties as reported by the detailer (-0.04 [-3.30, 3.38], p = 0.98).

Conclusion

The results slightly favor in-person visits and suggest that virtual detailing visits need to incorporate strategies that minimize technical difficulties and prevent participants from defaulting to less favorable technology. Future research opportunities include evaluating the effectiveness of a virtual versus in-person delivery of AD program on outcomes such as providers’ opioid prescribing behavior.

中文翻译：

---

关于阿片类药物处方的虚拟学术细节的可行性和可接受性

介绍

COVID-19 期间的社交距离要求对进行传统的学术详细介绍提出了挑战，传统的学术详细介绍通常涉及面对面的同伴教育访问，以改善患者的治疗效果。主要的替代方法是通过基于网络的技术进行虚拟学术详细介绍，但这种方法充满了许多挑战。本研究旨在检验在医疗保健提供者中实施的虚拟学术细节计划的可行性和可接受性。

方法

学术详细计划的重点是在提供者样本中适当的阿片类药物处方和慢性非癌症疼痛管理。最初的面对面访问随后是最多 8 周后的虚拟访问。视频会议用于进行虚拟访问，电话作为备份。评估虚拟访问是否可能发生的可行性，并通过提供者满意度评估可接受性。使用了具有 5 分李克特式量表的提供者对学术细节 (PSAD) 的满意度和访问效率的细节评估 (DAVE) 的经过验证的措施。更高的分数对应于更高的满意度和更高的感知效果。非参数和参数统计测试用于比较访问之间和组之间的仪器总结分数。

结果

在计划的 141 次访问中，完成了 127 次 (90%) 的初次亲自访问，调查回复率为 96%。在预定的 120 次虚拟随访中，进行了 92 次 (77%)，并收集了 56 次调查 (61%)。对初始和后续虚拟学术详细访问的满意度很高，但是，在参与两次访问并完成调查的提供者中（n = 50），初始访问的分数略高（平均差 = −2.94 [ 95% 置信区间：-4.38，-1.50]，p < 0.001）。从量表总分 (0.05 [−0.56, 0.66], p = 0.86) 和两个单独报告的与可行性相关的项目 (0.07 [−0.29, 0.42], p = 0.72) 和对话 (−0.05 [−0.28, 0.17], p = 0.63)。四十一 (44. 6 % 的虚拟访问是使用 WebEx 进行的，其中访问内容的视频和屏幕共享是可能的，而其余 51 (55.4 %) 是使用电话进行的。WebEx 与电话访问之间的提供商满意度没有显着差异 (-1.47 [-4.99, 2.05], p = 0.82)。提供者的满意度也没有受到细节设计者报告的任何技术困难的影响 (-0.04 [-3.30, 3.38], p = 0.98)。

结论

结果略微支持面对面访问，并表明虚拟详细访问需要包含最大限度地减少技术困难并防止参与者默认使用不太受欢迎的技术的策略。未来的研究机会包括评估虚拟与面对面交付 AD 计划对结果的有效性，例如提供者的阿片类药物处方行为。