A Quality Improvement Project to Investigate Individual Provider Variation in Opioid Prescribing From the Emergency Department

NCT02665429 | Completed

• 1 other identifier: H00009241
• Study Type: interventional
• Target: 109
• Locations: 1 country
• Sites: 3

Brief Summary

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.

Conditions

Analgesics, Opioid; Delivery of Health Care; Drug Prescribing; Over Prescribing; Prescribing Patterns, Physician; Practice Management, Medical; Practice Guidelines as Topic

Keywords

Emergency Medicine

Outcome Measures

Primary Outcomes (1)

• Change in number of opioid prescriptions per hundred patients seen

  Pre-intervention baseline compared to 1, 2, 3, 6, 9, 12 months post-intervention

Secondary Outcomes (3)

• 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

Other Outcomes (4)

• Self-assessment of decile for number of opioid prescriptions per hundred patients seen

  Once, at time of enrollment

• Self-assessment of decile for percentage of total prescriptions written that are opioids

  Once, at time of enrollment

• Self-assessment of decile for median quantity of pills dispensed per opioid prescription

  Once, at time of enrollment

Study Arms (2)

Control

NO INTERVENTION

Providers who are subject only to the routine implementation of clinical practice guidelines without additional experimental intervention

Intervention

EXPERIMENTAL

Providers who are subject to routine clinical practice guideline implementation AND receive provider's own individual prescribing data profile intervention ("Individual prescribing data profile and self-assessment")

Behavioral: Individual prescribing data profile and self-assessment

Interventions

Individual prescribing data profile and self-assessment BEHAVIORAL

Prior to receiving his or her individual data profile, each provider in the intervention group will be asked to identify his or her self-assessment of his or her own opioid prescribing practices. Immediately after providing self-perception data, providers will be provided with their true profile data with a visual display of where they fall within the distribution of their peers. All peer data are de-identified.

Intervention

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• None

Sponsors & Collaborators

• University of Massachusetts, Worcester: lead
• UMass Memorial Health: collaborator

Study Sites (3)

UMass Clinton Hospital

Clinton, Massachusetts, United States

Location

UMass Memorial Marlborough Hospital

Marlborough, Massachusetts, United States

Location

UMass Memorial Medical Center

Worcester, Massachusetts, United States

Location

MeSH Terms

Interventions

Diagnostic Self Evaluation

Intervention Hierarchy (Ancestors)

Diagnostic Techniques and Procedures; Diagnosis

Study Officials

• Sean Michael, MD

  UMass Memorial Health

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Emergency Medicine Administrative Leadership Fellow

Study Record Dates

• First Submitted: January 20, 2016
• First Posted: January 27, 2016
• Study Start: February 1, 2016
• Primary Completion: March 1, 2017
• Study Completion: March 1, 2017
• Last Updated: June 27, 2017

Record last verified: 2017-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (3)