Physician Coaching to Reduce Opioid-related Harms
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Substance Abuse
- Sponsor
- University of Wisconsin, Madison
- Enrollment
- 53132
- Locations
- 1
- Primary Endpoint
- Overall Rate of Opioid Prescribing
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
This project pilot tests an innovative clinical guideline translation and physician coaching model to promote adherence to evidence-based guidelines for the prescribing of opioid pain medications in primary care settings.
Detailed Description
This project addresses the urgent need to promote the adoption of evidence-based practices in healthcare by pilot-testing an innovative implementation strategy. The implementation strategy aims primarily to reduce variation in opioid prescribing practices for chronic pain in primary care settings. The standard approach to improving medical practice involves groups of clinical experts reviewing the literature to produce clinical guidelines based on scientific evidence, and disseminating those guidelines by publishing them in medical journals. A clinical guideline has been developed for opioid prescribing for chronic non-cancer pain using this type of approach. The implementation strategy for promoting uptake of the guideline in primary care settings tested in this study consists of three innovations: (1) a process for translating clinical guidelines into a checklist-based implementation guide for clinicians, (2) a physician peer coaching model, and (3) implementation support using tools from systems engineering. This project teams the experts who developed the guideline for opioid prescribing with experts in implementation science and primary care to translate the guideline into an actionable, checklist-based implementation guide. If the implementation strategy is effective in this pilot test, it will be used in a larger cluster-randomized trial to test it against other approaches to evidence-based practice adoption.The long-term goal of this research is to improve the adoption of evidence-based practices in primary care by producing a generalizable model of change.
Investigators
Eligibility Criteria
Inclusion Criteria
- •At each of the 4 coaching intervention sites, we aim to recruit between 3-7 clinical care providers with prescribing authority (e.g., primary care physicians, mid-level practitioners, etc.) to participate in interviews and focus groups. All clinic staff (e.g., medical assistants, office staff) are welcome to participate in coaching site visits and follow up correspondence, but only staff with prescribing authority will be considered research participants.
Exclusion Criteria
- •Residents will be excluded.
Outcomes
Primary Outcomes
Overall Rate of Opioid Prescribing
Time Frame: Up to 3 years
The proportion of patients with a chronic pain diagnosis receiving daily opioids.
Secondary Outcomes
- Rate of Opioid / Benzodiazepine Co-prescribing(Up to 3 years)
- Urine Drug Screening Rate(Up to 3 years)
- Mental Health Screening Rate(Up to 3 years)
- Use of Pain Management Agreements(Up to 3 years)
- High-dose Patients(Up to 3 years)
- Provider Drop-out Rate(3 months)
- Participating Patient Demographics(Up to 3 years)
- Participating Clinic Characteristics(Up to 12 months)
- Participating Staff Characteristics(Up to 12 months)
- Intervention Fidelity(Up to 12 months)
- Intervention Cost(Up to 12 months)
- Proportion With MEDD >120 mg(Up to 12 months)
- Average Morphine Equivalent Daily Dose (MEDD)(Up to 12 months)