Electronic Defaults to Reduce Opioid Prescribing in Dentistry Practices
- Conditions
- Acute Pain
- Interventions
- Other: Change in electronic health record default for new opioid analgesic prescriptions
- Registration Number
- NCT03030469
- 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 dentistry 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 three Montefiore Medical Center dentistry sites, 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
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 10000
- Dentistry clinic within Montefiore Medical Center
Patient Inclusion Criteria:
- Received a new opioid analgesic prescription, defined as no opioid analgesic prescription in the preceding 6 months
- None
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description 5-pill default Change in electronic health record default for new opioid analgesic prescriptions New opioid analgesic prescriptions will automatically default to 5 pills. 10-pill default Change in electronic health record default for new opioid analgesic prescriptions The intervention condition consists of a change to the electronic health record so that new opioid analgesic prescriptions automatically default to 10 pills (i.e., the "quantity dispensed" field is pre-populated). This value is modifiable by providers who can tailor the prescription based on clinical factors.
- Primary Outcome Measures
Name Time Method Initial prescription number of pills to dispense Through study completion (18 months) From the electronic health record
- Secondary Outcome Measures
Name Time Method Initial prescription morphine milligram equivalents to dispense Through study completion (18 months) From the electronic health record
Hospitalizations Within 30 days after the initial prescription From the electronic health record
Opioid analgesic reorder (y/n) Within 30 days after the initial prescription From the electronic health record
Total opioid analgesic pills to dispense, including re-orders Within 30 days after the initial prescription From the electronic health record
Outpatient visits Within 30 days after the index prescription From the electronic health record
Total morphine milligram equivalents to dispense, including re-orders Within 30 days after the initial prescription From the electronic health record
Emergency department visits Within 30 days after the initial prescription From the electronic health record