NCT03825549

Brief Summary

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.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
452

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Sep 2019

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 17, 2019

Completed
14 days until next milestone

First Posted

Study publicly available on registry

January 31, 2019

Completed
7 months until next milestone

Study Start

First participant enrolled

September 3, 2019

Completed
6 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 2, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 2, 2020

Completed
Last Updated

March 6, 2020

Status Verified

March 1, 2020

Enrollment Period

6 months

First QC Date

January 17, 2019

Last Update Submit

March 4, 2020

Conditions

Acute Pain

Keywords

OpioidsNudgesEmergency MedicineUrgent CareFeedback

Outcome Measures

Primary Outcomes (1)

  • Change in the mean number of pills per opioid prescription

    The primary outcome is the change in the mean number of pills prescribed per opioid prescription from baseline to the intervention period.

    Six months

Secondary Outcomes (1)

  • Change in proportion of patient visits with an opioid prescription

    Six months

Other Outcomes (3)

  • Change in morphine milligram equivalents per opioid prescription

    Six months

  • Change in mean number of opioid pills per patient-visit

    Six months

  • Change in proportion of patient-visits with non-opioid pain prescription

    Six months

Study Arms (4)

Control

NO INTERVENTION

No intervention

Individual Audit

EXPERIMENTAL

Clinicians will receive individual audit feedback informing them of their performance.

Behavioral: Individual audit feedback

Peer Comparison

EXPERIMENTAL

Clinicians will receive peer comparison feedback informing them of how their performance compares to their peers.

Behavioral: Peer comparison feedback

Individual Audit and Peer Comparison

EXPERIMENTAL

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.

Behavioral: Individual audit feedbackBehavioral: Peer comparison feedback

Interventions

Individual audit feedbackBEHAVIORAL

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.

Individual AuditIndividual Audit and Peer Comparison
Peer comparison feedbackBEHAVIORAL

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."

Individual Audit and Peer ComparisonPeer Comparison

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Clinicians
  • \. 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

You may not qualify if:

  • 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

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Sutter Heath

Walnut Creek, California, 94596, United States

Location

MeSH Terms

Conditions

Acute Pain

Condition Hierarchy (Ancestors)

PainNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Officials

  • Mitesh Patel, MD, MBA, MS

    University of Pennsylvania

    PRINCIPAL INVESTIGATOR

  • Amol Navathe, MD, PhD

    University of Pennsylvania

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 17, 2019

First Posted

January 31, 2019

Study Start

September 3, 2019

Primary Completion

March 2, 2020

Study Completion

March 2, 2020

Last Updated

March 6, 2020

Record last verified: 2020-03

Data Sharing

IPD Sharing
Will not share

Locations

US(1)