A Randomized Trial of Behavioral Economic Approaches to Reduce Unnecessary Opioid Prescribing
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Pennsylvania
- Enrollment
- 452
- Locations
- 1
- Primary Endpoint
- Change in the mean number of pills per opioid prescription
Study Overview
Brief Summary
In this study, the investigators will evaluate the effect of a health system initiative aiming to change clinician opioid prescribing behaviors using two behavioral economic interventions - individual audit feedback and peer comparison feedback of clinicians.
Detailed Description
Opioid-related abuse and overdose represent a growing national epidemic in the United States. Clinician practice patterns play an important role: opioid prescriptions impact the likelihood that patients will misuse or become dependent on these medications, with longer prescriptions leading to greater sustained use. In this study, we will evaluate a Sutter Health System quality improvement initiative using monthly individual audit feedback and/or monthly peer comparison feedback to clinicians to change opioid prescribing patterns. In partnership with Sutter Health System, this will be conducted using randomization to evaluate its effect. We will also conduct a process evaluation to understand factors associated with better or worse performance at the clinician level.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Factorial
- Primary Purpose
- Health Services Research
- Masking
- Double (Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Clinicians
- •Practiced primarily at participating emergency department or urgent care center
- •Presented to a participating emergency department or urgent care center during the study period
- •Discharged to home from the visit
Exclusion Criteria
- •Clinicians
- •Saw less than 100 patients in the prior year
- •Practiced primarily at another site that is not in the main trial
- •Did not practice at Sutter Health in the prior 90 days
- •Currently pregnant
Arms & Interventions
Control
No intervention
Individual Audit
Clinicians will receive individual audit feedback informing them of their performance.
Intervention: Individual audit feedback (Behavioral)
Peer Comparison
Clinicians will receive peer comparison feedback informing them of how their performance compares to their peers.
Intervention: Peer comparison feedback (Behavioral)
Individual Audit and Peer Comparison
Clinicians will receive individual audit feedback informing them of their performance and peer comparison feedback informing them of how their performance compares to their peers.
Intervention: Individual audit feedback (Behavioral)
Individual Audit and Peer Comparison
Clinicians will receive individual audit feedback informing them of their performance and peer comparison feedback informing them of how their performance compares to their peers.
Intervention: Peer comparison feedback (Behavioral)
Outcomes
Primary Outcomes
Change in the mean number of pills per opioid prescription
Time Frame: Six months
The primary outcome is the change in the mean number of pills prescribed per opioid prescription from baseline to the intervention period.
Secondary Outcomes
- Change in proportion of patient visits with an opioid prescription(Six months)