A Health System Wide Evaluation of Clinical Decision Support Tools to Improve PDMP Utilization and Patient Outcomes
2 other identifiers
observational
3,635
1 country
1
Brief Summary
This is a study comparing three clinical decision support (CDS) tools to enhance care by easing health care provider review of the Colorado prescription drug monitoring program (PDMP) prior to prescribing opioids (pain medications often called narcotics) or benzodiazepines (sedatives or muscle relaxants). The tools screen information from the PDMP (a statewide database of filled controlled medication) and a patient's medical record to identify high-risk factors for overdose. The tools only appear when relevant, are purely informational to facilitate an evidence-based practice (PDMP review) and do not dictate care or suggest changes in treatment. The study will track how each of the tools are used and if providers use the PDMP. Secondary outcomes include if a controlled medication prescription was written and future opioid use by patients.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for all trials
Started Feb 2021
Typical duration for all trials
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
February 16, 2021
CompletedFirst Submitted
Initial submission to the registry
June 2, 2021
CompletedFirst Posted
Study publicly available on registry
June 8, 2021
CompletedPrimary Completion
Last participant's last visit for primary outcome
May 30, 2023
CompletedStudy Completion
Last participant's last visit for all outcomes
November 30, 2023
CompletedResults Posted
Study results publicly available
September 16, 2025
CompletedSeptember 16, 2025
August 1, 2025
2.3 years
June 2, 2021
May 3, 2024
August 27, 2025
Conditions
Outcome Measures
Primary Outcomes (1)
Percentage of PDMP Checks Conducted During High-risk Prescriptions
Differences between groups in the percentage of opioid or benzodiazepine prescriptions with one or more high risk prescribing criteria for whom the health care provider consults the Prescription Drug Monitoring Program (PDMP) prior to signing, in line with prescribing best practices.
Total over the course of one year
Secondary Outcomes (2)
Percentage of High-risk Controlled Medication Prescriptions Abandoned
Total over the course of one year
Long Term Opioid Use
Total over the course of one year
Study Arms (4)
Provider Group 1: no alert
Control group to enable tracking of temporal changes in prescribing. Providers will not see any alert.
Provider Group 2: Mandated alert
Control group where providers will see a generic pop-up alert within the Electronic Health Record (EHR) whenever they initiate an opioid or benzodiazepine prescription without recording use of the PDMP. Patient risk factors are not assessed or presented in the alert. Providers in ambulatory clinics will not be assigned to this group. Alerts do not appear with patients with oncology or sickle cell diagnoses, or hospice discharge orders. Clinical Decision Support (CDS) alerts: CDS alerts are pop-up boxes integrated into the EHR. Each alert provides patient specific information, a link to the PDMP, instructions on how to dismiss the alert, a link to study-specific educational website, and a comment field.
Provider Group 3: PDMP alert
Providers will see a pop-up alert within the Electronic Health Record (EHR) when they initiate an opioid or benzodiazepine prescription without recording use of the PDMP and patients have one or more positive risk factors based on past/current prescriptions received. Patient risk factors are assessed and presented in the alert. Risk factors included are numbers of active or recent opioid and benzodiazepine prescriptions, overlapping prescriptions, co-prescribing of benzodiazepines and opioids, and use of long-acting opioids in opioid naïve patients. Alerts do not appear with patients with oncology or sickle cell diagnoses, or hospice discharge orders. Clinical Decision Support (CDS) alerts: CDS alerts are pop-up boxes integrated into the EHR. Each alert provides patient specific information, a link to the PDMP, instructions on how to dismiss the alert, a link to study-specific educational website, and a comment field.
Provider Group 4: PDMP + EHR alert
Providers will see a pop-up alert within the Electronic Health Record (EHR) when they initiate an opioid or benzodiazepine prescription without recording use of the PDMP and patients have one or more positive risk factors based on both prescriptions and other factors recorded in the patient's EHR. Patient risk factors are assessed and presented in the alert. Risk factors included the risks described in Group 3, along with a history of accidental opioid overdose, diagnosis of Opioid Use Disorder, multiple recent acute care incidents with opioid use, or high-risk psychiatric diagnoses. Alerts do not appear with patients with oncology or sickle cell diagnoses, or hospice discharge orders. Clinical Decision Support (CDS) alerts: CDS alerts are pop-up boxes integrated into the EHR. Each alert provides patient specific information, a link to the PDMP, instructions on how to dismiss the alert, a link to study-specific educational website, and a comment field.
Interventions
CDS alerts are pop-up boxes integrated into the EHR. Each alert provides patient specific information, a link to the PDMP, instructions on how to dismiss the alert, a link to study-specific educational website, and a comment field.
Eligibility Criteria
Provider population: Health care providers in Colorado who work in the University of Colorado Health (UCHealth) system. Patient population: Residents and visitors to the state of Colorado who seek healthcare within the UCHealth system.
You may qualify if:
- Licensed health care providers within the UCHealth system with a history (previous year) of prescribing opioids and/or benzodiazepines.
You may not qualify if:
- Majority of prescribing is done at a facility outside the state of Colorado
- Provider specialty of oncology or pediatrics as recorded in the EHR
- Provider in an ambulatory clinic where a total of \<50 opioid or benzodiazepine prescriptions were written in the year before study initiation
- Patient seen by a randomized provider within the UCHealth system who may receive an opioid prescription
- Less than 12 years of age or greater than 89 years of age at the time of the first study associated visit
- Active oncology or sickle cell diagnosis
- Active end of life care (defined as discharge to hospice or palliative care facility or specific palliative care orders in the medical record)
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
University of Colorado Hospital
Aurora, Colorado, 80045, United States
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Limitations and Caveats
Providers were randomized, health visits in which an opioid or benzodiazepine was prescribed were analyzed.
Results Point of Contact
- Title
- Heather Tolle
- Organization
- University of Colorado
Study Officials
- PRINCIPAL INVESTIGATOR
Jason A Hoppe, DO
University of Colorado School of Medicine
Publication Agreements
- PI is Sponsor Employee
- Yes
Study Design
- Study Type
- observational
- Observational Model
- OTHER
- Time Perspective
- PROSPECTIVE
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
June 2, 2021
First Posted
June 8, 2021
Study Start
February 16, 2021
Primary Completion
May 30, 2023
Study Completion
November 30, 2023
Last Updated
September 16, 2025
Results First Posted
September 16, 2025
Record last verified: 2025-08
Data Sharing
- IPD Sharing
- Will not share