Evaluation of Clinical Decision Support in Opioid Tapering
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 200,000
- 主要终点
- Percentage of encounters tapering within CDC guidelines
研究概览
简要总结
The 2022 Center for Disease Control and Prevention (CDC) clinical practice guideline for prescribing opioids for pain recommends that when tapering a patient's opioid dose, doses should be decreased at a slow rate to reduce the risk of withdrawal symptoms, overdose, and to promote tolerance of the tapering. This project will evaluate a clinical decision support (CDS) tool in the form of a clinical care pathway that gives providers information, recommendations, and educational material on strategies for opioid tapering. Primary care providers will be randomized at the clinic location to a control arm or intervention arm. The control arm will have the clinical care pathway available, but will not be reminded of the pathway when tapering a patient. The intervention arm will receive a nudge when prescribing a tapering opioid strategy to a patient to use the clinical care pathway. The rate of opioid tapering in line with CDC guidelines will be examined as well as long-term patient outcomes of opioid overdose or poisoning using existing patient health records. The study period will be approximately 18 months.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 12 Years 至 89 Years（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Primary care patients being tapered from an opioid. Tapering patients:
- •Have an active opioid prescription for more than 3 months and
- •Prescribed more than 90 morphine milligram equivalents (MME) per day or
- •Co-prescribed an opioid and benzodiazepine or
- •Received a reduction in opioid dosage by more than 5% MME per day
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
结局指标
主要结局
Percentage of encounters tapering within CDC guidelines
时间窗: 18 months
The number of encounters where a provider's actions are in line with CDC tapering guidelines divided by the total number of opioid tapering prescriptions
次要结局
- Subsequent opioid overdose/poisoning rates(6 months after taper encounter)
- Health care utilization(6 months after taper encounter)
- Clinical decision support (CDS) acceptance rate(18 months)