Reducing Inappropriate Prescription Opioid Prescribing at Hospital Discharge
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- RAND
- 入组人数
- 640
- 试验地点
- 1
- 主要终点
- Proportion of Discharges With Opioid Prescriptions Above Prescribing Guidelines
研究概览
简要总结
This study tests the effectiveness of two email-based behavioral nudges, one based on peer behavior and one based on best practice guidelines, in reducing excessive opioid prescriptions after surgery. It will be conducted in three surgical specialties (general surgery, orthopedic surgery, and obstetric/gynecological surgery) at 19 hospitals within one healthcare system. These specialties will each be randomized to a control group or one of two nudge groups. Each month for one year, surgeons in the nudge groups will receive emails comparing their opioid prescribing either to their peers' prescribing or to prescribing guidelines. Both types of email-based nudges are expected to reduce opioid prescribing after surgery.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Double (Participant, Care Provider)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •The nudges that a surgeon in either intervention arm will receive are based on that surgeon's eligible discharge opioid prescriptions in the previous month. Eligible prescriptions meet all of the following criteria:
- •the patient is at least 18 years old at the date of surgery
- •the patient is discharged to their home
- •the surgical procedure has an applicable post-operative opioid prescribing guideline
- •the surgical procedure is the only surgical procedure performed during the patient's hospital stay
- •the prescription is for an opioid taken orally (tablets, capsules, or liquid solution)
- •To avoid contamination between the intervention arms, surgeons who operate across multiple surgical specialties (defined as surgeons who performed less than 90% of their total procedures in one specialty between June 2020 and May 2021) will not be eligible.
排除标准
- 未提供
研究组 & 干预措施
Guideline-Based Nudges
干预措施: Guideline-Based (Injunctive Norm) Nudges (Behavioral)
Peer-Based Nudges
干预措施: Peer-Based (Social Norm) Nudges (Behavioral)
Control
结局指标
主要结局
Proportion of Discharges With Opioid Prescriptions Above Prescribing Guidelines
时间窗: 12 months
Prescriptions will be compared to prescribing guidelines via morphine milligram equivalents (MMEs) and coded as within or above guidelines. If no opioid is prescribed at discharge, this will be coded as within guidelines.
次要结局
- Morphine Milligram Equivalents (MMEs) Prescribed at Discharge(12 months)
- Days' Supply of Opioids Prescribed at Discharge(12 months)
- Proportion of Discharges Where Any Opioid Was Prescribed(12 months)
- Proportion of Patients on Opioids for Greater Than 3 Months Post-discharge(3-6 months post-discharge)
- Number of 30-day All-cause Emergency Department Visits(0-30 days post-discharge)
- Number of 30-day All-cause Hospitalizations(0-30 days post-discharge)
- Proportion of Discharge Opioid Prescriptions Above Prescribing Guidelines in the Year After the Intervention Ends(12 months (months 13-24 of the study))