Clinical Decision Support for Opioid Use Disorders in Medical Settings: Usability Testing in an EMR

Not Applicable

Completed

• Conditions: Opioid-use Disorder
• Interventions: Other: Opioid Wizard

• Registration Number: NCT03559179
• Lead Sponsor: HealthPartners Institute

Brief Summary

The primary objective of this pilot study is to program an opioid use disorder (OUD) clinical decision support (CDS) tool for use in an electronic medical record (EMR) and obtain high primary care physician (PCP) usability and acceptability. The OUD-CDS is based on the NIDA-Blending Initiative white paper, "Clinical Decision Support for Opioid Use Disorders: Working Group Report," which itself is based on national evidence-based guidelines (American Society of Addiction Medicine (ASAM 2015), VA (VA 2015). As such, this pilot study aims to help PCPs achieve accepted standards of care in OUD treatment. The secondary objectives of this pilot study are to evaluate the usefulness of the tool by comparing OUD case-finding, medication-assisted therapy (MAT) and referral patterns pre- and post-CDS deployment for PCPs with and without CDS access.

Detailed Description

Not available

Study Timeline

• Study Start: 2018-04-30
• Study First Submitted: 2018-05-09
• Study First Submitted QC: 2018-06-05
• Study First Posted: 2018-06-18
• Status Verified: 2019-02
• Primary Completion: 2019-02-14
• Study Completion: 2019-02-14
• Results First Submitted: 2020-01-29
• Results First Submitted QC: 2020-02-25
• Last Update Submitted: 2020-03-09
• Results First Posted: 2020-03-10
• Last Update Posted: 2020-03-17

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 55

Inclusion Criteria

• Be an MD, Doctor of Osteopathy, Nurse Practitioner or Physician's Assistant engaged in independent primary care of adults at HealthPartners or Park Nicollet
• Have at least schedule 3 DEA prescribing privileges
• Voluntarily provide written informed consent to participate in this study

Read More

Exclusion Criteria

• Less than half-time clinical primary care responsibilities

Read More

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Waivered Providers Receive the Opioid Wizard	Opioid Wizard	All providers who have a buprenorphine waiver will receive the OUD clinical decision support tool (Opioid Wizard).
Non-Waivered Providers who receive Opioid Wizard	Opioid Wizard	All non-buprenorphine waivered providers will be randomized to receive or not receive the Opioid. This arm of providers will receive the OUD clinical decision support tool (Opioid Wizard).

Primary Outcome Measures

Name	Time	Method
Intervention PCP Confidence in Assessing and Treating OUD	This outcome measure was calculated at approximately month 10 of the pilot study	# of intervention PCPs who report feeling "moderately" or "very" confident in assessing and treating OUD.
Intervention PCP Likeliness to Recommend Use of the OUD-CDS	This was calculated after PCP surveys were completed, approximately month 10	# of PCPs with CDS access who rate the OUD-CDS \>4 on a 5-point Likert scale of likeliness to recommend use of the tool to their colleagues. The scale ranges from 1-"not at all likely" to 5-"very likely," with higher values representing a higher likelihood of recommending the OUD-CDS to other colleagues.

Secondary Outcome Measures

Name	Time	Method
Compare Pre- and Post-intervention Rates of OUD Diagnosis in High-risk Patients.	This was calculated at the end of the pilot study (month 8).	Calculate and compare the number of patients diagnosed with OUD pre- and post-intervention. This will be presented as rate of OUD diagnoses per patient year.
Compare Pre- and Post-intervention Rates of Medication-assisted Therapy (MAT) Use.	This was calculated at the end of the pilot study (month 8).	Calculate and compare the rate of MAT use among patients with OUD pre- and post-intervention. This is presented as a pre/post ratio of MAT rx per patient year.
Compare Post-intervention Referral Patterns Between Intervention and Control Groups	This was calculated at the end of the pilot study (month 8).	Calculate and compare how often patients diagnosed with OUD are referred to specialty care or inpatient treatment post-intervention. Compare these rates between intervention and control groups.

Trial Locations

Locations (1)

HealthPartners; 🇺🇸 Bloomington, Minnesota, United States