Effect of Academic Detailing on Opioid Prescribing by Dentists to Adolescents and Young Adults

Effect of Academic Detailing on Opioid Prescribing by Dentists to Adolescents and Young Adults

This randomized controlled trial will test whether an academic detailing educational outreach intervention (referred to as "academic detailing" throughout) decreases opioid prescribing to patients aged 13-30 years among high-prescribing dentists in Southeast Michigan. The primary objective is to evaluate whether an academic detailing intervention reduces the number of dispensed opioid prescriptions to patients aged 13-30 years.

Using 2023 IQVIA Longitudinal Prescription Database, the study team will identify dentists in the 85th-94th percentile of dispensed opioid prescriptions to patients aged 13-30 years from January 1, 2023 through September 30, 2023 and practice in high-population counties in Southeast Michigan. The study team will randomize these dentists into two study arms. Dentists in the intervention arm will receive an academic detailing session focused on evidence-based pain management education. Dentists in the control will not receive any intervention and will not be contacted. Prescribing will be evaluated using IQVIA data for differential change in the number of dispensed opioid prescriptions to patients aged 13-30 years between the 8 months before and the 8 months after the academic detailing intervention period among intervention versus control dentists.

Inclusion Criteria for the practioners:

• General dentist, dental subspecialist, or oral and maxillofacial surgeon practicing in the State of Michigan that accounted for at least one dispensed opioid prescription to patients aged 13-30 years during January 1, 2023 through September 30, 2023.

Exclusion Criteria for the practioners:

• Dentist is not included in the OneKey database
• Dentist has an address in OneKey that corresponds to an academic institution (thus excluding residents/fellows and attendings at academic institutions)
• Dentist did not practice in a high-population county in Southeast Michigan, such as Wayne, Oakland, Macomb, Washtenaw, Ingham, Genesee, during the pre-intervention period (April 1, 2023 through November 30, 2023).
• Dentist was not in the 85th-94th percentile of dispensed opioid prescriptions to patients aged 13-30 years during January 1, 2023 through September 30, 2023.
• Dentist's practice address cannot be confirmed
• The dentist is no longer practicing as of the day before the beginning of the intervention period (December 1, 2023).
• The study team discovers after the time of randomization that dentists are either non-English speaking or have a medical or psychiatric condition that preclude participation in this project (in the judgment of the study team).
• The study team discovers after the time of randomization that the dentist moved to a practice location different from the one had at the time of randomization at any point between the time of randomization and the end of the study period in November 30, 2024. Practice location changes will be assessed based on IQVIA OneKey data as of November 2024. Additionally, the study team will call all included practices up to 2 times during November 2024 to confirm whether the dentist is still practicing at the location.
• The study team discovers after the time of randomization that the dentist stopped practicing dentistry between the time of randomization and the end of the study period on November 30, 2024 (e.g., retirement, death, etc.). This will be assessed using IQVIA (Longitudinal Prescription Database) OneKey data as of November 2024 and by calling practices in November 2024. Additionally, the study team will use 2024 IQVIA data to assess the number of dispensed antibiotic prescriptions in the post-intervention period across all age groups. If this number is zero, this might strongly suggest that the dentist is no longer practicing, as antibiotics are one of the most commonly prescribed classes of medications by dentists.