Clinical Decision Support for Safety of Opioid Transitions
- Conditions
- Medication AbuseHarm Reduction
- Interventions
- Other: Opioid Transitions Clinical Decision Support (CDS)
- Registration Number
- NCT06527040
- Lead Sponsor
- University of Colorado, Denver
- Brief Summary
The objective of this study is to evaluate the impact of clinical decision support (CDS) alert to notify providers when the opioid prescription being written will result in the patient transitioning into a new phase of opioid therapy. The 2022 CDC clinical practice guideline for prescribing opioids for pain recommends providers reassess patient pain as well as the risks and benefits of opioid therapy before patients transition from acute to subacute treatment (1 month of opioid analgesics) and when patients transition from subacute to chronic opioid treatment (3 months). This study will evaluate a clinical decision support tool identifying patients who will be transitioning between phases as a result of an opioid prescription and suggest a review of patient pain and goals. Primary care providers will be randomized at the clinic location to a control arm or intervention arm. The control arm will not be notified that the prescription transitions the patient to a new phase but will have access to the same patient pain scales and information. The intervention arm will receive a notification of the transition and suggest review of patient needs and encourage documentation. Opioid transition orders and outcomes of patients will be examined based on medical records data collected during routine care.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 200000
Any primary care encounter where an opioid is prescribed that transitions the patient to a different stage of opioid therapy (acute to subacute after 1 month of opioids; subacute to chronic after 3 months of an opioid)
- Patients <12 and >89
- Patients with active cancer diagnosis in last 1 year
- Patients with hospice care/palliative care order
- Patients with sickle cell disease diagnosis
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Clinical Decision Support (CDS): Opioid transition alert Opioid Transitions Clinical Decision Support (CDS) Encounters where the opioid transition clinical decision support (CDS) alert fired. CDS logic is programmed to fire the alert when a provider places an order for an opioid that will transition the patient from acute to subacute opioid therapy (at 30 days) or from subacute to chronic opioid therapy (at 90 days).
- Primary Outcome Measures
Name Time Method Percentage of encounters with an opioid transitioning prescription 18 months The number of primary care encounters where an opioid prescription transitions a patient to a different phase of care (by phase) divided by the total number of opioid prescriptions
- Secondary Outcome Measures
Name Time Method Opioid prescription abandonment 18 months The proportion of opioid prescriptions initiated (triggering the CDS) and an opioid was not signed by the provider, indicating a change in clinical decision to prescribe an opioid
Number of patients with long term opioid use Six months after an encounter where the opioid use disorder is identified Count of patients receiving \>90 day supply of opioids
Clinical decision support (CDS) acceptance rate 18 months The number of times providers accepted the Clinical decision support (CDS) tool and documented a review of patient pain and goals
Subsequent opioid overdose/poisoning rates Six months after an encounter where the opioid use disorder is identified The number of patients who reached the threshold of chronic opioid use, had a diagnosis of opioid overdose/poisoning or a new diagnosis of opioid use disorder