Effect of Default Electronic Health Record Settings on Clinician Opioid Prescribing Patterns in Emergency Departments
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 104
- 主要终点
- Dispense quantity of prescribed opioids
研究概览
简要总结
The investigators conducted a prospective, block-randomized study to determine whether and to what extent changes in the default settings in the electronic medical record (EMR) affect opioid prescriptions for patients discharged from emergency departments (EDs).
详细描述
In two large, urban emergency departments, we randomly altered the pre-populated dispense quantities of discharge prescriptions for commonly-prescribed opioids over a series of five 4-week blocks. These changes were made without announcement, and providers were not informed of the study itself.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Sequential
- 主要目的
- Health Services Research
- 盲法
- None
盲法说明
The investigators did not mask the changes to the electronic medical record, but note that they also did not announce them.
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Discharge prescription from emergency for study drug: hydrocodone/acetaminophen, oxycodone, or oxycodone/acetaminophen.
排除标准
- 未提供
研究组 & 干预措施
Null setting, forced entry
Each arm sets the default quantity (preset quantity) embedded in the electronic medical record for study opioids.
This arm has a default setting for opioid quantity set at -blank-. This setting required the prescriber to enter a quantity in order to write a prescription.
干预措施: Default settings for opioid prescriptions (acetaminophen/hydrocodone, oxycodone, acetaminophen/oxycodone) (Other)
5 tablet default
Each arm sets the default quantity (preset quantity) embedded in the electronic medical record for study opioids.
This arm has a default setting for opioid quantity set at 5.
干预措施: Default settings for opioid prescriptions (acetaminophen/hydrocodone, oxycodone, acetaminophen/oxycodone) (Other)
10 tablet default
Each arm sets the default quantity (preset quantity) embedded in the electronic medical record for study opioids.
This arm has a default setting for opioid quantity set at 10.
干预措施: Default settings for opioid prescriptions (acetaminophen/hydrocodone, oxycodone, acetaminophen/oxycodone) (Other)
15 tablet default
Each arm sets the default quantity (preset quantity) embedded in the electronic medical record for study opioids.
This arm has a default setting for opioid quantity set at 15.
干预措施: Default settings for opioid prescriptions (acetaminophen/hydrocodone, oxycodone, acetaminophen/oxycodone) (Other)
Status quo default setting
Each arm sets the default quantity (preset quantity) embedded in the electronic medical record for study opioids.
This arm has a default setting for opioid quantity set at the status quo value for each site (20 for site 1, 12 for site 2).
干预措施: Default settings for opioid prescriptions (acetaminophen/hydrocodone, oxycodone, acetaminophen/oxycodone) (Other)
结局指标
主要结局
Dispense quantity of prescribed opioids
时间窗: Through study completion, approximately 340 days
The dispense quantity of prescribed study drugs was collected from the electronic medical record at each site. The mean and median quantities per prescription according to each study arm were compared.
次要结局
- Proportion ≤12(Through study completion, approximately 340 days)
- Proportion at default setting(Through study completion, approximately 340 days)