About this trial
The objective of this study is to evaluate the impact of clinical decision support (CDS) alert to notify providers when the opioid prescription being written will result in the patient transitioning into a new phase of opioid therapy. The 2022 CDC clinical practice guideline for prescribing opioids for pain recommends providers reassess patient pain as well as the risks and benefits of opioid therapy before patients transition from acute to subacute treatment (1 month of opioid analgesics) and when patients transition from subacute to chronic opioid treatment (3 months). This study will evaluate a clinical decision support tool identifying patients who will be transitioning between phases as a result of an opioid prescription and suggest a review of patient pain and goals. Primary care providers will be randomized at the clinic location to a control arm or intervention arm. The control arm will not be notified that the prescription transitions the patient to a new phase but will have access to the same patient pain scales and information. The intervention arm will receive a notification of the transition and suggest review of patient needs and encourage documentation. Opioid transition orders and outcomes of patients will be examined based on medical records data collected during routine care.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
None
Disqualifiers
Patients <12 and >89
Patients with active cancer diagnosis in last 1 year
Patients with hospice care/palliative care order
Patients with sickle cell disease diagnosis
Trial population
Residents and visitors to the state of Colorado who seek healthcare within the University of Colorado Health (UCHealth) primary care system and receive an opioid prescription.
Trial design
Cohort
Prospective
Treatments tested in this trial
Opioid Transitions Clinical Decision Support (CDS)
Other interventionClinical decision support in the form of an electronic health record (EHR) integrated, provider-facing alert suggesting (a) the patient is transitioning to a new phase of opioid therapy and (b) the provider should review patient pain data and pain management goals as suggested by Center for Disease Control and Prevention (CDC) guidelines.
Treatment groups
Trial outcomes
Primary outcomes
Percentage of encounters with an opioid transitioning prescription
The number of primary care encounters where an opioid prescription transitions a patient to a different phase of care (by phase) divided by the total number of opioid prescriptions
Secondary outcomes
Clinical decision support (CDS) acceptance rate
The number of times providers accepted the Clinical decision support (CDS) tool and documented a review of patient pain and goals
Subsequent opioid overdose/poisoning rates
The number of patients who reached the threshold of chronic opioid use, had a diagnosis of opioid overdose/poisoning or a new diagnosis of opioid use disorder
Opioid prescription abandonment
The proportion of opioid prescriptions initiated (triggering the CDS) and an opioid was not signed by the provider, indicating a change in clinical decision to prescribe an opioid
Number of patients with long term opioid use
Count of patients receiving \>90 day supply of opioids
Locations
Sponsors and contacts
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University of Colorado, Denver
Lead sponsor
National Institutes of Health (NIH)
Collaborator
National Institute on Drug Abuse (NIDA)
Collaborator
This trial is not recruiting at the moment. You can still explore other options: