Impact of feedback of prescribing portraits for individual prescribers - opioid naivete

Not Applicable

Completed

• Conditions: Opioid-sparing pain management; Signs and Symptoms

• Registration Number: ISRCTN34246811
• Lead Sponsor: Therapeutics Initiative, University of British Columbia

Brief Summary

2021 Protocol article in https://pubmed.ncbi.nlm.nih.gov/34082074/ (added 04/06/2021) 2022 Other publications in https://pubmed.ncbi.nlm.nih.gov/35543305/ Development of intervention and results of pilot study (added 12/05/2022) 2023 Results article in https://pubmed.ncbi.nlm.nih.gov/37802223/ primary outcome for a 6-month window before vs. after each mailed intervention (added 10/10/2023) 2022 Results article in https://www.doi.org/10.1097/CXA.0000000000000135 incidence of opioid analgesic initiations (added 21/12/2023)

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2020-04-10
• Study Completion: 2023-12-12
• Last Update Posted: 8 January 2024

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 4416

Inclusion Criteria

Current participant inclusion criteria as of 03/09/2021:
Physicians:
1. Currently actively treating patients (active prescriber is defined as having prescribed any medications at least 100 times in 2019 to eliminate retired or mostly retired physicians. For the 100 prescriptions, we counted only the number of dispensations recorded in the database without any restriction on patients)
2. Physicians defined as a 'General Practitioner' with a license status of 'Private Practice' according to Medical Services Plan (MSP = BC’s public insurance program)
3. Physicians who have a functioning postal address.

Patients:
1. Aged =19 years

Previous participant inclusion criteria as of 06/01/2021:
1. Physicians currently treating patients (defined as having prescribed any medications at least 100 times in 2019)
2. Have prescribed at least one opioid during the study period

Previous participant inclusion criteria:
1. Physicians currently treating patients (defined as having written at least 25 prescriptions, for any drug, in the preceding 12 months)
2. Have prescribed at least one opioid during the study period

Exclusion Criteria

Current participant exclusion criteria as of 03/09/2021:
Physicians:
1. Currently residing outside of BC
2. Prescribed less than one opioid analgesic to an opioid-naïve patient during the study period
3. Opted out of the Portrait program or recorded as retired or deceased in the database

Exclusion criteria - Participating patients:
1. Have been dispensed any opioids or opioid agonist therapies in the last six months (i.e., during the washout period)
2. Have been on Plan B (long term care) or Plan P (palliative care) at any time during the washout period or study period (as a proxy for non-cancer causes)
3. Have been without continuous Medical Services Plan (MSP = BC’s public insurance program) during the washout period and study period
4. Have had a cancer diagnosis or record of chemotherapy recorded in MSP fee-for-service claims, the hospital discharge abstract database, or the National Ambulatory Care Reporting System database during the study period or the preceding six months. Skin cancers (Basal Cell Carcinoma, Squamous Cell Carcinoma) were not excluded.

Previous participant exclusion criteria as of 06/01/2021:
Prescribers:
1. Currently residing outside of BC
2. Unavailable contact information (e.g., deceased, retired)
3. Not currently practicing (are retired), or who have not prescribed at least one opioid during the study period

Patients:
1. Have been dispensed any opioids or opioid agonist therapies in the last six months (during the washout period)
2. On Plan B (long term care) or Plan P (palliative care) at any time during the washout period or study period (as a proxy for non-cancer causes)
3. Have been without continuous Medical Services Plan (public insurance program) during the washout period and study period
4. Have had a cancer diagnosis (not including skin cancers) or record of chemotherapy recorded in MSP fee-for-service claims, the hospital discharge abstract database, or the National Ambulatory Care Reporting System database during the study period or the preceding six months

Previous participant exclusion criteria:
1. Currently residing outside of BC
2. Unavailable contact information (e.g., deceased, retired)
3. Not currently practicing (are retired), or who have not prescribed at least one opioid during the study period

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Current primary outcome measure as of 03/09/2021:<br>The number of new opioid prescriptions initiated in opioid-naïve patients in the 6 months following the intervention, as recorded in the BC Ministry of Health administrative claims databases<br><br><br>Previous primary outcome measure:<br>The number of new opioid prescriptions to opioid-naïve patients in the last 12 months, calculated based on the administrative claims databases of the Ministry of Health in the last 6 months at the 6-month follow up.