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临床试验/NCT03584789
NCT03584789已完成不适用

De-Implementing Opioid Use and Implementing Optimal Pain Management Following Dental Extractions

HealthPartners Institute1 个研究点 分布在 1 个国家目标入组 5,722 人开始时间: 2020年2月17日最近更新:
适应症
干预措施

试验速览

阶段
不适用
状态
已完成
入组人数
5,722
试验地点
1
主要终点
Opioid Prescribing at the Extraction Encounter

研究概览

简要总结

The overarching goal of this project is to de-implement the reliance on opioid analgesics and to implement reliance on non-opioid analgesics to manage postoperative pain following dental extractions. Using a prospective, provider-level, 3-arm cluster randomized trial design, the investigators will compare different strategies to reduce the reliance on opioids and increase the use of alternative pain management approaches utilizing information support tools aimed at both providers and their patients.

详细描述

The primary objective of this project is to de-implement the use of opioid analgesics for the management of postoperative pain following dental extractions and to implement effective alternative pain management. The investigators propose a cluster-randomized trial design in which dental practitioners will be randomly assigned to 1 of 3 conditions involving different implementation strategies. The first condition, Standard Practice, will serve as a control condition. The second condition will implement a clinical decision support (CDS) tool that will extract patient history and interface with the state prescription drug monitoring program to provide personalized recommendations for analgesic prescribing and offer language for discussing optimal, evidence-based non-opioid pain management with dental extraction patients. The third condition will involve an enhanced version of the CDS (CDS-E) that will also include information regarding optimal, evidence-based, non-opioid pain management delivered directly to the patient both before and following the dental extraction visit. The investigators will examine opioid and non-opioid prescribing data from the electronic health record across study arms as well as other provider- and patient-focused outcomes using mixed methods.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Health Services Research
盲法
None

入排标准

年龄范围
16 Years 至 —(Child, Adult, Older Adult)
性别
All
接受健康志愿者
否

入选标准

  • •Inclusion Criteria:
  • •Have a dental extraction of a permanent teeth performed by an eligible HealthPartners provider during the intervention period

排除标准

  • •Patients who have opted out of research at HealthPartners
  • •Meet above age criteria

研究组 & 干预措施

Standard Practice

No Intervention

The patients in this arm were part of usual care with their dental provider.

Clinical Decision Support

Experimental

A clinical decision support system designed to assist dentists in providing optimal pain management for patients without resorting to opioids when a non-opioid alternative would suffice. It provides pertinent clinical information to the dentist, including point-of-care access to the Prescription Drug Monitoring Program.

干预措施: Clinical Decision Support (Other)

Clinical Decision Support + Education

Experimental

Patient education regarding pain management before and after dental extraction, including information about the risks and benefits of various strategies.

干预措施: Clinical Decision Support (Other)

Clinical Decision Support + Education

Experimental

Patient education regarding pain management before and after dental extraction, including information about the risks and benefits of various strategies.

干预措施: Patient education (Other)

结局指标

主要结局

Opioid Prescribing at the Extraction Encounter

时间窗: At the extraction encounter

Number of participants prescribed an opioid.

次要结局

  • Compare the Study Arm Differences in Patient Experiences of Post-extraction Pain(3-6 days after the extraction encounter)
  • Compare the Study Arm Differences in Shared Decision-making(3-6 days after the extraction encounter)
  • Exclusive Non-opioid Prescribing or Recommendations at the Extraction Encounter(At the extraction encounter)

研究者

申办方类型
Other
责任方
Sponsor

研究点 (1)

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