Scaling Interoperable Clinical Decision Support for Patient-Centered Chronic Pain Care
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 39
- 试验地点
- 1
- 主要终点
- Adoption
研究概览
简要总结
This study will adapt and scale existing AHRQ-supported interoperable CDS for patient-centered chronic pain care. The objective of this project is to study the adaptation and implementation of an existing interoperable CDS tool for pain treatment shared decision making, with tailored implementation support, in primary care clinical settings. The central hypothesis is that tailored implementation support will increase CDS adoption and shared decision making.
详细描述
This study will adapt and scale the use of existing AHRQ-supported interoperable CDS that aids patient-centered chronic pain treatment decision making. The research will generate critical evidence on scalable strategies to implement and evaluate interoperable CDS in real-world settings across different types of EHRs. The pragmatic trial will enhance the reach of interoperable CDS to more diverse populations. Together, these efforts will lead to important new technology and evidence that patients, clinicians, and health systems can use to improve care for millions of Americans who suffer from pain and other chronic conditions.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Primary care patients receiving care at a participating clinic
- •Patients with chronic non-cancer musculoskeletal pain and with a recent history of opioid use
排除标准
- •Due to the fact that the clinical decision support tool is currently available in English only, non-English speaking patients will not be eligible to participate
研究组 & 干预措施
Pain Manager + tailored implementation support Pain Manager
Pain Manager is a decision support tool. All study clinics will begin the trial with Pain Manager integrated and available in their EHR. Consistent with the stepped-wedge design, intensive implementation support (e.g, administrative support, technical support)will be provided to two clinics at once by a multidisciplinary team.
干预措施: Pain Manager + tailored implementation support (Behavioral)
Pain Manager implementation in EHR
Pain Manager is a decision support tool. All study clinics will begin the trial with Pain Manager integrated and available in their EHR. The other 6 clinics will have no additional tailor support.
结局指标
主要结局
Adoption
时间窗: During the implementation trial (5 months total)
Rate of qualifying patients seen for whom CDS use is documented
次要结局
- Reach(During the implementation trial (5 months total))
- Shared decision making(Immediately after the intervention)
- Pain and function(Baseline/pre-intervention, and at 1 and 3 months)
- Any opioid prescription(Baseline/pre-intervention, and at 1 and 3 months)
- Opioid prescriptions ≥50 MME/day(Baseline/pre-intervention, and at 1 and 3 months)
- Opioid prescriptions ≥90 MME/day(Baseline/pre-intervention, and at 1 and 3 months)
- Benzodiazepine prescription concurrent with opioid prescription(Baseline/pre-intervention, and at 1 and 3 months)
- Prescriptions for non-opioid pain medications(Baseline/pre-intervention, and at 1 and 3 months)
- Prescriptions for non-pharmacologic pain treatments(Baseline/pre-intervention, and at 1 and 3 months)
- Urine drug screen orders(Baseline/pre-intervention, and at 1 and 3 months)
- Naloxone prescriptions(Baseline/pre-intervention, and at 1 and 3 months)
- Prescription or referral for medication-assisted therapy (MAT)(Baseline/pre-intervention, and at 1 and 3 months)