Impact Evaluation of the Therapeutic Initiative's Prescribing Portrait and Therapeutics Letter on Opioid Use by Dentists

NCT07317869 | Not Yet Recruiting

• 1 other identifier: H25-03753
• Study Type: interventional
• Target: 3,498
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to estimate the impact of providing personalized prescribing data and educational materials on opioid prescribing to dentists in British Columbia, Canada. The main research questions are:

1. 1.What is the impact of an intervention on the use of opioids for dental pain? The intervention includes a personalized prescribing report (a "Portrait"), brief educational summary, and patient education materials; and
2. 2.Does the impact of the intervention increase when dentists are also invited to attend facilitated audit-and-feedback group sessions and to develop a practice improvement plan? Using administrative health data, the prescribing of those in different combinations of materials in the Early Group will be compared to those in the Delayed Group to estimate the impact of the materials on prescribing by the dentists.

Conditions

Clinical Audit; Quality Improvement; Opioid; Dentistry

Keywords

Randomized controlled trial; Prescribing feedback; Quality improvement; Opioid

Outcome Measures

Primary Outcomes (2)

• The number of opioid prescriptions per dentist

  The primary outcome is the change from baseline in the number of opioid prescriptions per dentist. The primary measures of effect will be absolute differences between trial arms, differences in prescribing trends over time, and difference-in-differences estimates comparing the intervention period with the pre-intervention period.

  From baseline to 12 months post interventions. The baseline is the 12-month period before the date when the prescriber is mailed the intervention bundle.

• Total morphine milligram equivalents (MME) prescribed per dentist

  The primary outcome is the change from baseline in the total morphine milligram equivalents (MME) prescribed per dentist. The primary measures of effect will be absolute differences between trial arms, differences in prescribing trends over time, and difference-in-differences estimates comparing the intervention period with the pre-intervention period.

  From baseline to 12 months post interventions. The baseline is the 12-month period before the date when the prescriber is mailed the intervention bundle.

Secondary Outcomes (1)

• Rate ratios between trial arms

  From baseline to 12 months post intervention. The baseline is the 12-month period before the date when the prescriber is mailed the intervention bundle.

Study Arms (3)

Arm A (Group 1) - Regular intervention bundle

EXPERIMENTAL

Arm A/Group 1 receives the "regular" intervention bundle.

Behavioral: Regular intervention

Arm B (Group 2) - Enhanced intervention

EXPERIMENTAL

Arm B/Group 2 receives the "enhanced" intervention bundle

Behavioral: Enhanced intervention

Arm C (Group 3) - Delayed control

EXPERIMENTAL

Arm C/Group 3 is a delayed control group that receives the "regular" intervention materials 12 months after the Arm A and B receive their interventions.

Behavioral: Regular intervention

Interventions

Regular intervention BEHAVIORAL

The "regular" intervention bundle consists of a personalized prescribing "Portrait" showing dentists their opioid prescribing volume and duration over the past five years compared with the provincial median. The Portrait is accompanied by a Therapeutics Letter summarizing evidence-based recommendations for dental pain management, emphasizing that NSAIDs with or without acetaminophen provide similar or better pain control than opioids and are associated with fewer adverse events. Dentists also receive a patient education handout addressing common questions about opioid use for dental pain.

Arm A (Group 1) - Regular intervention bundle; Arm C (Group 3) - Delayed control

Enhanced intervention BEHAVIORAL

For the "enhanced" intervention bundle, dentists receive all components of the regular intervention, plus and invitation to participate in facilitated peer audit-and-feedback group sessions to review prescribing data, identify practice gaps, develop improvement strategies, and commit to change. Participants also receive an updated personalized Portrait (updated data) at approximately six months, followed by additional facilitated sessions to review new data and reassess practice enhancement strategies.

Arm B (Group 2) - Enhanced intervention

Eligibility Criteria

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

You may qualify if:

• Dentists will be eligible to receive an individual prescribing Portrait if they meet all of the following criteria:
• Registered with the British Columbia Medical Services Plan (MSP) as being in active practice;
• Have a valid mailing address in British Columbia; and
• Issued ≥10 prescriptions dispensed at community pharmacies between January 5, 2025 and January 5, 2026, as identified in PharmaNet claims data.
• Received an opioid prescription from an eligible dentist during the study period (January 6, 2026 to January 6, 2027);
• The opioid prescription was issued by a dentist; and
• Were continuously enrolled in the British Columbia Medical Services Plan (MSP) during the 12 months prior to the opioid prescription.

You may not qualify if:

• Patients will be excluded if they meet any of the following criteria:
• Had a medication dispensed under Plan P in the 12 months prior to the opioid prescription; or
• Filled a prescription for opioid agonist therapy (OAT) within 180 days prior to the opioid prescription.

Sponsors & Collaborators

• University of British Columbia: lead
• Ministry of Health, British Columbia: collaborator

Study Sites (1)

Therapeutics Initiative - Dept of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia

Vancouver, British Columbia, V6T 1Z3, Canada

Location

Study Officials

• Colin Dormuth, ScD

  University of British Columbia

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Ellen M Reynolds, MPA

CONTACT

1-250-208-4889; ellen.reynolds@ubc.ca

Dana Stanley, MET

CONTACT

1-250-590-5955; dana.stanley@ubc.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Dentists will not be masked to their group allocation but will not be aware of the trial arm variations being evaluated or the analytical approach. The statistical analysis plan is being developed by an evaluation committee who are masked to the trial arm allocation.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Investigators randomized actively practicing dentists into three groups, n = 1166 in each group. Groups 1 will receive the "regular" intervention and Group 2 will receive the "enhanced" intervention materials on January 6 2026, while Group 3 will serve as a delayed control and will receive the "regular" intervention 12 months after Groups 1 and 2.

Study Record Dates

• First Submitted: December 19, 2025
• First Posted: January 5, 2026
• Study Start: January 6, 2026
• Primary Completion (Estimated): January 6, 2027
• Study Completion (Estimated): January 31, 2028
• Last Updated: January 8, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)