A Randomized Trial of Behavioral Economic Approaches to Reduce Unnecessary Opioid Prescribing (REDUCE)
2020年3月4日 更新者：University of Pennsylvania
In this study, the investigators will evaluate the effect of a health system initiative aiming to change clinician opioid prescribing behaviors using two behavioral economic interventions - individual audit feedback and peer comparison feedback of clinicians.
研究概览
详细说明
Opioid-related abuse and overdose represent a growing national epidemic in the United States.
Clinician practice patterns play an important role: opioid prescriptions impact the likelihood that patients will misuse or become dependent on these medications, with longer prescriptions leading to greater sustained use.
In this study, we will evaluate a Sutter Health System quality improvement initiative using monthly individual audit feedback and/or monthly peer comparison feedback to clinicians to change opioid prescribing patterns.
In partnership with Sutter Health System, this will be conducted using randomization to evaluate its effect.
We will also conduct a process evaluation to understand factors associated with better or worse performance at the clinician level.
研究类型
介入性
注册 (实际的)
452
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
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California
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Walnut Creek、California、美国、94596
- Sutter Heath
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 及以上 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
Clinicians
1. Practiced primarily at participating emergency department or urgent care center
Patients
- Presented to a participating emergency department or urgent care center during the study period
- Discharged to home from the visit
Exclusion Criteria:
Clinicians
- Saw less than 100 patients in the prior year
- Practiced primarily at another site that is not in the main trial
- Did not practice at Sutter Health in the prior 90 days
Patients
- Currently pregnant
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：卫生服务研究
- 分配：随机化
- 介入模型：阶乘赋值
- 屏蔽：双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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无干预：控制
无干预
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实验性的：Individual Audit
Clinicians will receive individual audit feedback informing them of their performance.
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Practice sites randomly assigned to have individual audit feedback will be sent information by email to each clinician at the site each month for the duration of the intervention period.
The email will inform the clinician that the health system is doing monthly audits and provide them the number of patients in the last month for whom they prescribed 30 opioid pills per prescription or higher.
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实验性的：Peer Comparison
Clinicians will receive peer comparison feedback informing them of how their performance compares to their peers.
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Practice sites randomly assigned to have peer comparison feedback will be sent information by email to each clinician at the site each month for the duration of the intervention period.
Data on the mean number of opioid pills per prescription and the proportion of visits with an opioid prescription will be delivered using a 3-month rolling average as follows: a) If clinician is above median: informed how their data compares to the median; b) If clinician is below median but above 10th percentile: informed how their data compares to the 10th percentile; c) If clinician is 10th percentile or below: informed of their data and commended for being a "low prescriber."
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实验性的：Individual Audit and Peer Comparison
Clinicians will receive individual audit feedback informing them of their performance and peer comparison feedback informing them of how their performance compares to their peers.
|
Practice sites randomly assigned to have individual audit feedback will be sent information by email to each clinician at the site each month for the duration of the intervention period.
The email will inform the clinician that the health system is doing monthly audits and provide them the number of patients in the last month for whom they prescribed 30 opioid pills per prescription or higher.
Practice sites randomly assigned to have peer comparison feedback will be sent information by email to each clinician at the site each month for the duration of the intervention period.
Data on the mean number of opioid pills per prescription and the proportion of visits with an opioid prescription will be delivered using a 3-month rolling average as follows: a) If clinician is above median: informed how their data compares to the median; b) If clinician is below median but above 10th percentile: informed how their data compares to the 10th percentile; c) If clinician is 10th percentile or below: informed of their data and commended for being a "low prescriber."
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Change in the mean number of pills per opioid prescription
大体时间：Six months
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The primary outcome is the change in the mean number of pills prescribed per opioid prescription from baseline to the intervention period.
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Six months
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Change in proportion of patient visits with an opioid prescription
大体时间：Six months
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The secondary outcome is the change in proportion of patient visits in which an opioid is prescribed from baseline to the intervention period.
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Six months
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Change in morphine milligram equivalents per opioid prescription
大体时间：Six months
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The change in morphine milligram equivalents per opioid prescription from baseline to the intervention period.
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Six months
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Change in mean number of opioid pills per patient-visit
大体时间：Six months
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The change in the mean number of opioid pills per patient-visit from baseline to the intervention period.
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Six months
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Change in proportion of patient-visits with non-opioid pain prescription
大体时间：Six months
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The change in proportion of patient-visits with non-opioid pain prescriptions (e.g., ibuprofen, acetaminophen, celecoxib, or muscle relaxants such as cyclobenzaprine, baclofen or tizanidine) from baseline to the intervention period.
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Six months
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Amol Navathe, MD, PhD、University of Pennsylvania
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2019年9月3日
初级完成 (实际的)
2020年3月2日
研究完成 (实际的)
2020年3月2日
研究注册日期
首次提交
2019年1月17日
首先提交符合 QC 标准的
2019年1月29日
首次发布 (实际的)
2019年1月31日
研究记录更新
最后更新发布 (实际的)
2020年3月6日
上次提交的符合 QC 标准的更新
2020年3月4日
最后验证
2020年3月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.