Physician Coaching to Reduce Opioid-related Harms

NCT02433496 | Completed Results

• 2 other identifiers: 2015-02801R34DA036720-01A1
• Study Type: observational
• Target: 53,132
• Locations: 1 country
• Sites: 1

Brief Summary

This project pilot tests an innovative clinical guideline translation and physician coaching model to promote adherence to evidence-based guidelines for the prescribing of opioid pain medications in primary care settings.

Conditions

Substance Abuse; Chronic Pain

Keywords

Opioid

Outcome Measures

Primary Outcomes (1)

• Overall Rate of Opioid Prescribing

  The proportion of patients with a chronic pain diagnosis receiving daily opioids.

  Up to 3 years

Secondary Outcomes (13)

• Rate of Opioid / Benzodiazepine Co-prescribing

  Up to 3 years

• Urine Drug Screening Rate

  Up to 3 years

• Mental Health Screening Rate

  Up to 3 years

• Use of Pain Management Agreements

  Up to 3 years

• High-dose Patients

  Up to 3 years

Study Arms (2)

Physician coaching

This group includes 4 intervention primary care clinics that are part of the University of Wisconsin's Department of Family Medicine. These clinics will receive an organizational coaching intervention that includes in-person site visits and phone/email communication. Each participating clinic will designate one primary care physician to act as a clinic lead in working with the coach to coordinate an initial site visit (during project month 13, July 2015), a follow-up site visit (month 15, October, 2015), and communicating with the coach throughout the 6-month follow-up period via phone and email.

Other: Physician coaching

Control Group

This group includes 4 control primary care clinics that will not receive any intervention. A de-identified dataset will be created to examine differences in outcome variables between intervention and control clinics.

Interventions

Physician coaching OTHER

The coach will present the latest research on the benefits and risks of long-term opioid use. The presentation will be followed by a brainstorming exercise where the coach joins the clinic team in experiencing clinical practices from the perspective of a patient with chronic pain. The coach will help the clinic team flowchart clinical workflows and determine the best course for implementing aspects of a checklist-based implementation guide developed to support adoption of the guidelines for opioid prescribing. The coach will help the team implement ideas using Plan-Do-Study-Act change cycles. The coach will maintain monthly email and phone contact with the clinic lead and clinic team after the initial site visit to monitor implementation progress and offer advice.

Physician coaching

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Clinicians with prescribing authority at community-based primary care clinics

You may qualify if:

• At each of the 4 coaching intervention sites, we aim to recruit between 3-7 clinical care providers with prescribing authority (e.g., primary care physicians, mid-level practitioners, etc.) to participate in interviews and focus groups. All clinic staff (e.g., medical assistants, office staff) are welcome to participate in coaching site visits and follow up correspondence, but only staff with prescribing authority will be considered research participants.

You may not qualify if:

• Residents will be excluded.

Sponsors & Collaborators

• University of Wisconsin, Madison: lead
• National Institute on Drug Abuse (NIDA): collaborator
• Center for Health Enhancement System Studies: collaborator

Study Sites (1)

University of Wisconsin - Madison

Madison, Wisconsin, 53705, United States

Location

Related Publications (1)

• Quanbeck A, Brown RT, Zgierska AE, Jacobson N, Robinson JM, Johnson RA, Deyo BM, Madden L, Tuan WJ, Alagoz E. A randomized matched-pairs study of feasibility, acceptability, and effectiveness of systems consultation: a novel implementation strategy for adopting clinical guidelines for Opioid prescribing in primary care. Implement Sci. 2018 Jan 25;13(1):21. doi: 10.1186/s13012-018-0713-1.

  PMID: 29370813 DERIVED

MeSH Terms

Conditions

Substance-Related Disorders; Chronic Pain

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders; Mental Disorders; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Limitations and Caveats

The UWHealth system introduced a new opioid-prescribing policy concurrent with the beginning of the study period and included a standardized treatment agreement that included elements of the checklist developed during this research.

Results Point of Contact

• Title: Andrew Quanbeck
• Organization: University of Wisconsin - Madison

arquanbe@wisc.edu

6082627385

Study Officials

• Andrew R Quanbeck, PhD

  Center for Health Enhancement Systems Studies

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 20, 2015
• First Posted: May 5, 2015
• Study Start: July 1, 2014
• Primary Completion: June 30, 2017
• Study Completion: June 30, 2017
• Last Updated: July 6, 2018
• Results First Posted: July 6, 2018

Record last verified: 2018-07

Locations

US (1)