PRescribing INterventions for Chronic Pain Via the Electronic Health Record Study - Primary Care Providers
PRINCE
2 other identifiers
interventional
472
1 country
1
Brief Summary
The objective of this research is to assess the effects of electronic health record (EHR)-based decision support tools on primary care provider (PCP) decision-making around pain treatment and opioid prescribing. The decision support tools are informed by principles of "behavioral economics," whereby clinicians are "nudged," though never forced, towards guideline-concordant care.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Aug 2020
1 active site
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
Study Start
First participant enrolled
August 26, 2020
CompletedFirst Submitted
Initial submission to the registry
October 19, 2020
CompletedFirst Posted
Study publicly available on registry
October 23, 2020
CompletedPrimary Completion
Last participant's last visit for primary outcome
October 1, 2021
CompletedStudy Completion
Last participant's last visit for all outcomes
October 1, 2021
CompletedResults Posted
Study results publicly available
June 27, 2024
CompletedJune 27, 2024
June 1, 2024
1.1 years
October 19, 2020
April 4, 2024
June 4, 2024
Conditions
Outcome Measures
Primary Outcomes (1)
Frequency of PDMP Checks
Outcome is reported as the mean number of times an individual Primary Care Provider checks the Prescription Drug Monitoring Program per month.
12 months
Secondary Outcomes (7)
PCP Satisfaction #1
12 months
PCP Satisfaction #2
12 months
PCP Satisfaction #3
12 months
PCP Satisfaction #4
12 months
PCP Satisfaction #5
12 months
- +2 more secondary outcomes
Study Arms (4)
Care as Usual
NO INTERVENTIONClinics assigned to this arm will continue to care for the patients as usual in regards to opioid prescribing.
Choice Architecture Nudge
EXPERIMENTALClinics in this arm will receive the choice architecture nudge intervention.
PMP Integration & Nudge
EXPERIMENTALClinics in this arm will receive the Prescription Drug Monitoring (PMP) Integration \& Nudge intervention.
Choice Architecture Nudge + PMP Integration & Nudge
EXPERIMENTALClinics in this arm will receive both the choice architecture nudge and prescription drug monitoring (PMP) integration \& nudge interventions.
Interventions
Primary Care Providers (PCPs) will be sent alerts in the Electronic Health Record system when they initiate an opioid order for a patient who has not had an opioid prescription within the past six months. The alert provides guidance language about opioid prescribing and prompts the PCP to open the "SmartSet" to order non-opioid treatment alternatives. When the SmartSet is opened, PCPs can choose to click on a variety of treatment order options, including both non-opioid pharmacological options and non-pharmacological options. PCPs will also be sent alerts when they initiate an opioid order for a patient will a current opioid prescription. The alerts prompt PCPs to consider tapering the patient's opioid. The alert also displays the MME of the patient's current opioid prescription and automatically calculates what a 10% reduction in MME relative to the current prescription would be. The alert contains options to either cancel the refill order, or to continue with the order.
During the Prescription Drug Monitoring Program (PMP) integration \& nudge intervention, Primary Care Providers (PCPs) will have integrated access to the PMP embedded within the EHR. All clinicians can already access the PMP to look up a patient's prior opioid prescriptions and prescription fills. However, this process involves signing in to the separate PMP website and can be complicated and time-consuming within typical clinical workflow. The integrated PMP tool makes it much easier and faster for a PCP to access the PMP information for a given patient.
Eligibility Criteria
You may qualify if:
- \- All primary care providers from all of the Fairview and University of Minnesota Physicians study clinics
You may not qualify if:
- \- Primary care providers who work less than 20% full time equivalent (FTE)
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- University of Minnesotalead
- National Institute on Drug Abuse (NIDA)collaborator
Study Sites (1)
University of Minnesota
Minneapolis, Minnesota, 55455, United States
Related Publications (1)
Neprash HT, Vock DM, Hanson A, Elert B, Short S, Karaca-Mandic P, Rothman AJ, Melton GB, Satin D, Markowitz R, Golberstein E. Effect of Integrating Access to a Prescription Drug Monitoring Program Within the Electronic Health Record on the Frequency of Queries by Primary Care Clinicians: A Cluster Randomized Clinical Trial. JAMA Health Forum. 2022 Jun 5;3(6):e221852. doi: 10.1001/jamahealthforum.2022.1852. eCollection 2022 Jun.
PMID: 35977248DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Results Point of Contact
- Title
- Ezra Golberstein
- Organization
- University of Minnesota
Study Officials
- PRINCIPAL INVESTIGATOR
Ezra Golberstein, PhD
University of Minnesota
Publication Agreements
- PI is Sponsor Employee
- Yes
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- OUTCOMES ASSESSOR
- Purpose
- PREVENTION
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
October 19, 2020
First Posted
October 23, 2020
Study Start
August 26, 2020
Primary Completion
October 1, 2021
Study Completion
October 1, 2021
Last Updated
June 27, 2024
Results First Posted
June 27, 2024
Record last verified: 2024-06