A Quality Improvement Project to Investigate Individual Provider Variation in Opioid Prescribing From the Emergency Department
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 109
- 试验地点
- 3
- 主要终点
- Change in number of opioid prescriptions per hundred patients seen
研究概览
简要总结
This is a study of emergency physicians' prescribing patterns related to opioid (narcotic) medications. We are trying to determine whether giving providers access to their own prescribing data influences their prescribing patterns.
详细描述
Opioid misuse is a known public safety threat and public health problem, both nationwide and in the Commonwealth of Massachusetts. As a part of these efforts, Emergency Department (ED) outpatient prescriptions have been identified as a potential area for improvement. The Massachusetts Hospital Association (MHA), in conjunction with other stakeholders, developed a set of recommendations to address opioid management and prescribing within the ED setting.
This study is timed to coincide with the rollout by UMassMemorial Health Care of a system-wide opioid prescribing practice guideline/policy which mirrors the Massachusetts Hospital Association's guideline. This rollout provides a unique opportunity for a natural experiment related to provider prescribing practices.
This is a quality improvement project with two primary objectives:
- Improve understanding of physician practice patterns related to emergency department (ED) opioid prescribing
- Evaluate the effectiveness of providing individual clinician profile data in influencing behavior change among ED providers, as it relates to their opioid prescribing patterns
There are two corresponding specific aims:
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
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Provider who practices Emergency Medicine in one or more of four UMass-affiliated EDs (UMassMemorial Medical Center, Marlborough Hospital, and Clinton Hospital), including attending physicians, resident physicians, and advanced practice providers (PAs and NPs).
- •Have placed at least one electronic prescription for a medication of interest (namely opioids) in the PulseCheck electronic medical record system during the 12 months prior to the implementation of the opioid guidelines
- •Be actively practicing in a UMass-affiliated ED at time of implementation of the guidelines
排除标准
- 未提供
结局指标
主要结局
Change in number of opioid prescriptions per hundred patients seen
时间窗: Pre-intervention baseline compared to 1, 2, 3, 6, 9, 12 months post-intervention
次要结局
- Change in percentage of total prescriptions written that are opioids(Pre-intervention baseline compared to 1, 2, 3, 6, 9, 12 months post-intervention)
- Change in median quantity of pills dispensed per opioid prescription(Pre-intervention baseline compared to 1, 2, 3, 6, 9, 12 months post-intervention)
- Change in number of prescriptions for long-acting opioid formulations(Pre-intervention baseline compared to 1, 2, 3, 6, 9, 12 months post-intervention)
研究者
Sean Michael
Emergency Medicine Administrative Leadership Fellow
University of Massachusetts, Worcester