Electronic Defaults to Reduce Opioid Prescribing in Emergency Department and Primary Care Settings

Not Applicable

Completed

• Conditions: Acute Pain

• Registration Number: NCT03003832
• Lead Sponsor: Montefiore Medical Center

Brief Summary

The goal of this research is to investigate the impact of changing opioid analgesic prescribing defaults on the quantity of opioids prescribed for acute non-cancer pain in adult primary care and emergency department settings. We will change prescribing defaults for select short-acting opioid analgesics including immediate release oxycodone and hydrocodone as well as codeine and tramadol, including their co-formulations with acetaminophen. In a cluster-randomized trial of matched pairs of Montefiore Medical Center clinical sites, stratified by specialty and teaching status, we will evaluate the impact of this intervention on patient-level outcomes using 18 months of data (6 months pre-intervention and 12 months post-intervention).

Detailed Description

Not available

Study Timeline

• Study Start: 2016-12
• Study First Submitted: 2016-12-06
• Study First Submitted QC: 2016-12-22
• Study First Posted: 2016-12-28
• Primary Completion: 2018-07-13
• Study Completion: 2018-07-13
• Status Verified: 2018-08
• Last Update Submitted: 2018-08-13
• Last Update Posted: 2018-08-14

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 15000

Inclusion Criteria

• Primary care clinic (internal medicine, family medicine, or urgent care) or emergency department within Montefiore Medical Center

Patient Inclusion Criteria:

• Received a new opioid analgesic prescription, defined as no opioid analgesic prescription in the preceding 6 months

Patient

Exclusion Criteria

• Cancer diagnosis code within the past 1 year

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Initial prescription <= 10 pills (y/n)	Through study completion (18 months)	Extracted from the electronic medical record

Secondary Outcome Measures

Name	Time	Method
Initial prescription number of pills	Through study completion (18 months)	Extracted from the electronic medical record
Initial prescription morphine milligram equivalents	Through study completion (18 months)	Extracted from the electronic medical record
Total morphine milligram equivalents prescribed, including re-orders	Within 30 days after the initial prescription	Extracted from the electronic medical record
Opioid analgesic re-order (y/n)	Within 30 days after the initial prescription	Extracted from the electronic medical record
Hospitalizations	Within 30 days after the initial prescription	Extracted from the electronic medical record
Outpatient visits	Within 30 days after the initial prescription	Extracted from the electronic medical record
Total opioid analgesic pills prescribed, including re-orders	Within 30 days after the initial prescription	Extracted from the electronic medical record
Emergency department visits	Within 30 days after the initial prescription	Extracted from the electronic medical record