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NaRCAD2020: Sharing a Vision of Sustainability - Shared screen with speaker view
Harald Chr. Langaas
32:09
Good evening from Norway!
Winnie Ho, NaRCAD
32:23
Hi all! Please make sure to change your name on zoom to ‘First Name Last Name’ so we all can address you properly! You can do this by clicking on the three dots next to your Zoom video/screen and selecting ‘Rename'
Vishal Kinkhabwala
33:04
Hello everyone!
jerry avorn
33:09
Welcome all, from the US, Norway, and everywhere else!
Cheryl Radeloff
33:17
Good morning!
Carolyn Wilson
33:17
New London, CT
Mary Nagy (she/her)
34:06
Good morning from Michigan!
Heather Barto
35:58
Hi all from NH! Super excited for this!
Winnie Ho, NaRCAD
38:21
Discussion Forum: https://www.narcad.org/forum.html
Luigi Ferrer he/him
42:38
Good Morning!
Christine (Chaoui) and Aaron Fishman
43:26
hello!
Megan Pruitt
47:00
Charleston
HarrisAF
47:08
Miami
Debra Rowett
48:17
Hello from South Australia :)
Wayne Smith
48:51
Hello from Nashville Tennessee
Jessica Alward
49:37
Yay!! Good job Winnie and Anna.
Winnie Ho, NaRCAD
01:13:02
MedRxiv: https://www.medrxiv.org/
Jean Stilwell
01:20:10
Inspiring message!
Bevin Shagoury, NaRCAD
01:21:06
Thanks, Jean! We're trying to stay positive.
Alisen Guyet
01:22:36
difficule to heqr
Lisa Shields-Oregon
01:35:30
this is fantastic. was there any messaging on lethal means reduction, or “only” depression treatment?
Nerissa Caballes
01:41:43
Sounds like a great campaign! Sorry if I missed it, but could you clarify who the psychotherapy detailers are i.e. pharmacists, LCSW, LCPC, etc?
Aleta Christensen
01:42:21
This is fabulous! Are these results published yet? Particularly interested in the results around adaptiveness.
Cindy Biederman
01:42:26
Were you able to capture data on therapy starts because it is all on the same EHR?
Winnie Ho, NaRCAD
01:43:25
I am bumping Lisa Shields’ question from earlier!: “this is fantastic. was there any messaging on lethal means reduction, or “only” depression treatment?”
Kelly Kretzer
01:44:39
What was the perception from the providers of being detailed in a non-peer to peer setting?
Bevin Shagoury, NaRCAD
01:48:03
Thank you, Sara, for a great first field presentation!
Todd Lee
02:01:52
Mark - is the slope that you drew you conclusion from based on adjusted changes that accounts for any differences in stations across the groups? I realize that is a bit of a challenge given the small N but the AD stations could do lots of things better -- what i'm curious about is whether the AD facilities are higher performing facilities across all kinds of indicators of care performance. Tough to attribute the effect to AD.
Lena Salach
02:01:59
Hello…I’m sorry if this was mentioned but curious about timelines. From launch of visit to data pull.
Anna Gribble
02:04:36
Has the VA's Academic Detailing program incorporated the VA's benzo tapering resource? It's a large (but great) document, any lessons learned on how to detail on benzo tapering? Or was the focus of detailing visits more on opioid tapering?
Dr. Alena Balasanova
02:05:04
is the benzo tapering document from the VA widely available?!
Bevin Shagoury, NaRCAD
02:06:54
Hi, Luigi! Please text NaRCAD1108 to 22333
Daina Wells
02:06:57
Yes, they are on our public site. We can put the link in
Bevin Shagoury, NaRCAD
02:07:08
Thanks, Daina! :)
Dr. Alena Balasanova
02:07:31
Thank you so much Daina, the link would be super helpful!
Daina Wells
02:07:34
Detailers have access to resources on both opioid tapers and benzo tapers. The provider and patient used shared decision making to decide which to taper and discontinue safely.
Daina Wells
02:08:22
https://www.pbm.va.gov/PBM/academicdetailingservicehome.asp
Mark Bounthavong (Presenter)
02:08:33
Thanks, Daina!
Daina Wells
02:08:35
can someone outside the VA network test that link and let me know if it works correctly?
Winnie Ho, NaRCAD
02:08:50
The link works!
Daina Wells
02:08:54
Great, thanks
Bevin Shagoury, NaRCAD
02:09:47
Thank you, Mark!
Bevin Shagoury, NaRCAD
02:10:26
We always appreciate your expertise and team based approach. You're all such a critical national network for AD and we're consistently lucky to learn from you all.
Mark Bounthavong (Presenter)
02:10:36
@Todd: Great question! Happy to chat off line. We used a fixed effects model bc of that very concern. Station may have some unobserved time-invariant confounders that make them better at reducing oiioid-bzd prescribing. However, with fixed effects model, we can’t really control for the unobserved time-varying confounders, so we included things like the # of prescriptions over time, # of outpatient visits over time, etc. in our model.
Daina Wells
02:11:24
You can click on the icon on that page to get to the catalog of our materials. Or here is the direct link: https://www.pbm.va.gov/PBM/AcademicDetailingService/EducationalMaterialCatalog_Publicsite.pdf
Bevin Shagoury, NaRCAD
02:12:01
@Mark, thanks for sharing your response to Todd's question! Happy to intro you both via e-mail this afternoon! :)
Bevin Shagoury, NaRCAD
02:12:58
@Daina: thanks so much for sharing resources with everyone!
Cheryl Radeloff
02:14:53
Mark and Sara, I'd love more information on the process that the VA set up AD within the organization
Sadie Liller
02:19:13
Will we have access to these materials?
Bevin Shagoury, NaRCAD
02:19:41
Hi, Sadie. We're happy to ask Nate to share these on our archive.
Sadie Liller
02:23:39
Thank you!
Jeri Tennant
02:25:46
I really appreciate this concrete example of getting a program up and running for those of us at the beginning of this journey!
jerry avorn
02:26:13
It’s so wonderful to see the many creative ways people are putting academic detailing to use across so many fronts. Excellent work!
Jacki Travers (she/her)
02:28:13
Did you see any differences between independent and chain pharmacies?
JULIE FITCH (she/her)
02:28:31
I have the same question Jacki.
Joanna Buxkemper
02:29:51
I am curious if you interacted more with any one type of pharmacy versus another (ie independent vs chain pharmacy vs grocery) - just bearing in mind the extreme time pressures that face most pharmacists practicing in a chain environment and if you were able to overcome that barrier.
Joanna Buxkemper
02:30:24
So, same question! haha
Bevin Shagoury, NaRCAD
02:30:36
Thanks, Joanna!
LaTonyua.Rice
02:30:39
How provide to chains that do not allow detailing
Bevin Shagoury, NaRCAD
02:30:41
You shared some of the nuances.
Bevin Shagoury, NaRCAD
02:31:23
We have time for one more question!
Cheryl Radeloff
02:32:41
This was great and extremely helpful !
Bevin Shagoury, NaRCAD
02:33:25
Any other questions for Nate? We're happy to triage!
Anna Morgan, NaRCAD
02:34:23
Zoom Link for AD 101 Breakout: https://partners.zoom.us/j/83777509612?pwd=Y0Vxa1RyQUNPOW5OejN4TFNlM09YZz09Zoom Link for Storytelling Breakout: https://partners.zoom.us/j/88270384982?pwd=cTdGeW1Ub2JUNXNyUEdQZDdRL3dMZz09Zoom Link for Build-A-Brand Breakout: https://partners.zoom.us/j/81443642707?pwd=WlRvL3RXTEtaSE1CMDZCdEo5eXFqUT09
Lisa Bullard-Cawthorne
02:34:56
I really miss the great food that Bevin typically orders for lunch:)
Anna Morgan, NaRCAD
02:34:58
Breakouts:https://www.narcad.org/breakouts.html
Cassidy Quillen (she/her)
02:34:59
These breakouts won't be recorded, right?
Winnie Ho, NaRCAD
02:35:07
The breakout sessions won’t be recorded!
Anna Morgan, NaRCAD
02:35:08
No, the breakouts will not be recorded!
Sadie Liller
05:10:27
Did that 92% include opioids or benzo's?
Bevin Shagoury, NaRCAD
05:12:57
Great q, Sadie! I'll ask Jenn during Q+A!
Justin Turner, Presenter
05:16:29
The 92% was a hypothetical question, it didn’t relate to any specific medication that was being taken by the participant
Bevin Shagoury, NaRCAD
05:17:02
@Justin: Thanks for context! @Sadie: let us know if you have further q's on this poll!
Sadie Liller
05:17:33
I can see where those who are on these medications may be reluctant to tapering off of them.
Nerissa Caballes
05:18:55
How did you get your foot in the door with the NH to provide AD services? I think it'd be a great target for education and deprescribing.
Jacki Travers (she/her)
05:29:22
Wondering if staff turnover had any impact on your efforts? For one of our long-term care projects, we felt like we were constantly having to go back to the beginning and re-educate new staff.
Jana McNulty
05:30:31
As an academic detailer in Ontario Canada- when we did “benzodiazepine use in older adults” as topic, we often supplemented our visits with physicians with the EMPOWER trial brochure… and it was always well received with physicians always wanting copies of it. Thank you Justin for making my job a little easier! :)
Sadie Liller
05:31:40
Thank you!
Justin Turner, Presenter
05:33:36
@Jane that’s great to hear :-)
Bevin Shagoury, NaRCAD
05:34:09
@Jana--agreed, thanks for positive feedback!
Bevin Shagoury, NaRCAD
05:34:18
Always great for morale and for folks to feel their work is impactful. :)
Loren Regier
05:40:03
Did you have any input/feedback from GI specialists at any point in the project/detailing process?
Elisabeth Fowlie Mock (she/her)
05:40:06
please unshare your screen so we can see more of your faces
Loren Regier
05:40:33
Did you have any family feedback of interest?
Teresa Grund
05:46:09
As you increase the consultant pharmacist CPA and scope of practice, do you plan on using AD as an avenue to educate those pharmacist on their prescribing practices?
Brenda Schuster
05:46:36
terminology is so important both for patient and in the literature…also how we define things. When I speak about deprescribing it does include dose reduction as you don’t always know where the story ends. So in your study a dose reduction was not considered a successful intervention.
Jane Luby
05:46:41
De-pharming sounds much better.
Winnie Ho
05:46:58
Just in case anyone didn’t catch that - the full acronym is: DE-PHARM Project, which stands for the "Discussion to Ensure the Patient-centered, Health-focused, Prognosis-appropriate and Rational Medication regimen"
Bevin Shagoury, NaRCAD
05:47:46
@Winnie, thanks so much!
Bevin Shagoury, NaRCAD
05:48:11
@Brenda: Great points and reflections! :)
Bevin Shagoury, NaRCAD
05:49:40
We have time for 1 or 2 more questions! Anyone?
Teresa Grund
05:51:02
Thank you ! I'd like to see how that looks for you in the future.
Sadie Liller
05:53:44
Great day!!!
Sadie Liller
05:54:06
You guys have the virtual platform down!
Michele Narsinghani, IL ADVANCE
05:54:14
Great presentation!
Vishal Kinkhabwala
05:54:27
This was fantastic - thank you!
Melissa.Christopher@va.gov
05:54:33
Great Information thanks so much for sharing on this topic, so critical to improving safe prescribing.
Sadie Liller
05:54:40
This was great!
Paul Fanikos
05:54:46
Fantastic!
Chelsie Dever
05:54:50
This was so informative and ran smoothly!
Cindy Biederman
05:55:13
focus on health disparities
Debra Rowett
05:55:41
Thankyou it has been a great night :)
Cindy Biederman
05:56:38
recruitment for virtual program
Justin Turner, Presenter
05:56:46
Thanks everyone for your great questions :-)
Justin Turner, Presenter
05:56:53
Thanks NaRCAD for a great day
Brian Abascal (he/him)
05:58:01
Thanks all!
Nerissa Caballes
05:58:04
Thanks so much to all the presenters and to NaRCAD!
Anna Morgan, NaRCAD
05:58:17
Evaluationhttps://www.narcad.org/eval.html
Vishal Kinkhabwala
05:58:20
Thanks NaRCAD for a great first day!
Loren Regier
05:58:28
Great Day 1!
Jenn Pruskowski (Presenter)
05:58:33
Thanks everyone - my email is jpruskow@pitt.edu for anyone who wants to reach out or be sent anything
Elisabeth Fowlie Mock (she/her)
05:59:58
one person in my breakout was on at 2am!!
Justin Turner, Presenter
05:59:59
There are heaps of free, evidence-based deprescribing resources at www.deprescribingnetwork.ca and also www.deprescribing.org
Janet
06:00:01
Great job!
Lauren Linder
06:00:42
really enjoyed day 1 thank you all!
Reem El-ankar
06:02:12
Thank you for everything. I did enjoy it.
Winnie Ho
06:02:39
If you’re interested in telling your NaRCAD story, we also are always looking for folks to interview for our DETAILS blog!
Kemi Popoola
06:02:56
thanks for a great first day!