Clinical Decision Support for Safety of Opioid Transitions
概览
- 阶段
- 不适用
- 干预措施
- Usual Care
- 疾病 / 适应症
- Medication Abuse
- 发起方
- University of Colorado, Denver
- 入组人数
- 200000
- 主要终点
- Percentage of encounters with an opioid transitioning prescription
- 状态
- 尚未招募
- 最后更新
- 11天前
概览
简要总结
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.
研究者
入排标准
入选标准
- •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)
排除标准
- •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
研究组 & 干预措施
Usual Care
Control group of contemporary encounters where clinical decision support alert is not active. Usual care.
Clinical Decision Support (CDS): Opioid transition alert
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).
干预措施: Opioid Transitions Clinical Decision Support (CDS)
结局指标
主要结局
Percentage of encounters with an opioid transitioning prescription
时间窗: 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
次要结局
- Opioid prescription abandonment(18 months)
- Number of patients with long term opioid use(Six months after an encounter where the opioid use disorder is identified)
- Clinical decision support (CDS) acceptance rate(18 months)
- Subsequent opioid overdose/poisoning rates(Six months after an encounter where the opioid use disorder is identified)