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Published on: June 10, 2013
County-Level Opioid Prescribing Behavior Before and After the Implementation of Local Opioid Overdose Prevention and
Laura J Cremer1, April Wisdom1, Jaswinder K Legha1
1Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, Atlanta, Georgia, USA.
Background:
The Centers for Disease Control and Prevention offered a multicomponent intervention called Local Opioid Overdose Prevention and Response (LOOPR). Five sites (Bell, KY, Boone, WV, Manchester, NH, St. Francois, MO, and Ware, GA) were selected to implement academic detailing (AD). AD is a strategy for communicating safer opioid prescribing practices to clinicians. This is the first study to assess changes in county-level opioid prescribing behaviors after implementing a multicomponent prevention program emphasizing AD.
Objectives:
We examined three opioid prescribing behaviors (percentage of opioid prescribers in the top centile nationally, opioid prescribing rate, and average number of opioid prescriptions per prescriber) before and after program implementation in each site and a paired control. We used paired interrupted time series to examine the effect of LOOPR on each outcome for each site and control.
Results:
Five jurisdictions incorporated AD as part of LOOPR. In addition, Bell County, KY implemented three other interventions (coalition establishment, communication campaign, and community-based overdose prevention program). Manchester City, NH (community-based overdose prevention program and public health/public safety partnership) and St. Francois, MO (communication campaign and public health/public safety partnership) implemented two additional interventions. Boone County, WV and Ware County, GA only incorporated AD. Though not always statistically significant, all sites showed decreasing or stabilizing trends after implementation of LOOPR for most outcomes.
Conclusions/Importance:
This study shows AD is a versatile strategy and customizable activity that can be implemented in many settings as a separate activity or integrated with various prevention programs, making it particularly suitable for community-level interventions.
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