{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T13:13:06Z","timestamp":1780751586359,"version":"3.54.1"},"reference-count":39,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Benzodiazepine use in the US Veterans Administration (VA) has been decreasing; however, a small number of veterans with posttraumatic stress disorder (PTSD) continue to receive benzodiazepine. Academic detailing, a targeted-educational outreach intervention, was implemented at VA to help reduce the disparity between existing and evidence-based practices, including the reduction in benzodiazepine use in veterans with PTSD. Since evidence to support the national implementation of academic detailing in this clinical scenario was scarce, we performed a quality improvement evaluation on academic detailing's impact on benzodiazepine use in veterans with PTSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort design was used to evaluate the impact of academic detailing on benzodiazepine prescribing in veterans with PTSD from January 1, 2016, to December 31, 2016. Providers exposed to academic detailing (AD-exposed) were compared with providers unexposed to academic detailing (AD-unexposed) using generalized estimating equations (GEEs) controlling for baseline covariates. Secondary aims evaluated academic detailing's impact on average lorazepam equivalent daily dose (LEDD), total LEDD, and benzodiazepine day supply.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, there was a decrease in the prevalence in benzodiazepine use in veterans with PTSD from 115.5 to 103.3 per 1000 population (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). However, the decrease was greater in AD-exposed providers (18.37%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001) compared with AD-unexposed providers (8.74%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). In the GEE models, AD-exposed providers had greater reduction in the monthly prevalence of veterans with PTSD and a benzodiazepine prescription compared with AD-unexposed providers, by \u22121.30 veterans per 1000 population (95% confidence interval [CI]: \u22122.14, \u22120.46). Similar findings were reported for the benzodiazepine day supply; however, no significant differences were reported for total and average LEDD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although benzodiazepine use has been decreasing in veterans with PTSD, opportunities to improve prescribing continue to exist at the VA. In this quality improvement evaluation, AD-exposed providers were associated with a greater reduction in the prevalence of veterans with PTSD and a benzodiazepine prescription compared with AD-unexposed providers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1080\/08897077.2019.1573777","type":"journal-article","created":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T15:09:53Z","timestamp":1552576193000},"page":"101-109","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Impact of Academic Detailing on Benzodiazepine Use among Veterans with Posttraumatic Stress Disorder"],"prefix":"10.1177","volume":"41","author":[{"given":"Mark","family":"Bounthavong","sequence":"first","affiliation":[{"name":"Academic Detailing Service, Pharmacy Benefits Management Services, US Department of Veterans Affairs, San Diego, California, USA;"},{"name":"The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos K.","family":"Lau","sequence":"additional","affiliation":[{"name":"Academic Detailing Service, Pharmacy Benefits Management Services, US Department of Veterans Affairs, San Diego, California, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah J.","family":"Popish","sequence":"additional","affiliation":[{"name":"Academic Detailing Service, Pharmacy Benefits Management Services, US Department of Veterans Affairs, San Diego, California, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad L.","family":"Kay","sequence":"additional","affiliation":[{"name":"Academic Detailing Service, Pharmacy Benefits Management Services, US Department of Veterans Affairs, San Diego, California, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daina L.","family":"Wells","sequence":"additional","affiliation":[{"name":"Academic Detailing Service, Pharmacy Benefits Management Services, US Department of Veterans Affairs, San Diego, California, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julianne E.","family":"Himstreet","sequence":"additional","affiliation":[{"name":"Academic Detailing Service, Pharmacy Benefits Management Services, US Department of Veterans Affairs, San Diego, California, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Academic Detailing Service, Pharmacy Benefits Management Services, US Department of Veterans Affairs, San Diego, California, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa L. D.","family":"Christopher","sequence":"additional","affiliation":[{"name":"Academic Detailing Service, Pharmacy Benefits Management Services, US Department of Veterans Affairs, San Diego, California, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,1,1]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Courtois CA Sonis J Brown LS . Clinical practice guidelines for the treatment of PTSD. 2017; Available at: http:\/\/www.apa.org\/ptsd-guideline\/ptsd.pdf. Accessed December 16 2017."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_3_3_4_2","unstructured":"Tanielian T Jaycox LH Adamson DM . Invisible wunds of war. 2008. Available at: https:\/\/www.rand.org\/pubs\/monographs\/MG720.html. 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