Clinical Decision Support to Increase Use of Medications for Opioid Use Disorder
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 200,000
- 试验地点
- 1
- 主要终点
- Percentage of patients at risk for opioid use disorder receiving medications for opioid use disorder
研究概览
简要总结
The objective of this study is to evaluate the impact of clinical decision support (CDS) in the form of an alert to identify patients who may be at risk of opioid use disorder (OUD) and a clinical care pathway helping providers treating patients with opioid use disorder. The pathway provides health care providers with information and suggestions for screening and treatment of opioid use disorder, including treatment with medications. The 2022 Centers for Disease Control and Prevention (CDC) clinical practice guideline for prescribing opioids for pain recommends providers asses for and treat opioid use disorder using approved medications for opioid use disorder (MOUD). This project will implement a passive CDS alert when a provider prescribes an opioid to a patient who may be at risk of opioid use disorder. Providers will also have link access to a clinical care pathway providing support for OUD screening and treatment. Before and after comparisons of buprenorphine (a medication used to treat opioid use disorder) prescribing by providers and outcomes of patients will be examined based on medical records data collected during routine care. The study period will be approximately 18 months.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 12 Years 至 89 Years（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Primary care encounter AND
- •Current opioid prescription (not buprenorphine) and Active opioid medications over the last 90 days OR
- •Documented as on local Pain Registry "Does the patient fit the criteria to be included on the Pain Registry?" OR
- •Has active problem list diagnosis of long-term (current) use of opiate analgesic OR
- •Is taking >=90 morphine milligram equivalents (MME) per day OR
- •Prior positive toxicology screen for illicit drugs OR
- •Diagnosis of opioid use disorder
排除标准
- •Active cancer diagnosis in the last 1 year
- •Hospice care/palliative care order
- •Sickle cell disease diagnosis
研究组 & 干预措施
pre implementation period
Encounters with a high risk opioid prescription prior to intervention implementation. Providers will not see any alert.
CDS Notification
Providers will see a clinical decision support tool within the electronic health record when treating a patient at risk for opioid use disorder to encourage the provider to use a clinical care pathway to assess for opioid use disorder and when applicable, treat opioid use disorder with buprenorphine. Smart text will also be available in the electronic health record so that the provider can easily document screening and treatment discussions with the patient.
干预措施: Medications for Opioid Use Disorder Pathway Clinical Decision Support (CDS) (Other)
结局指标
主要结局
Percentage of patients at risk for opioid use disorder receiving medications for opioid use disorder
时间窗: 18 months
The number of primary care patients identified to be at risk for opioid use disorder treatment with buprenorphine for treatment divided by the total number of patients meeting opioid use disorder criteria
次要结局
- Buprenorphine initiation(Six months after an encounter where the opioid use disorder is identified)
- Clinical decision support (CDS) acceptance rate(18 months)
- Subsequent opioid overdose/poisoning rates(Six months after an encounter where the opioid use disorder is identified)