Acute Pain
Conditions
Brief summary
The goal of this research is to investigate the impact of changing opioid analgesic prescribing defaults on the quantity of opioids prescribed for acute non-cancer pain in adult primary care and emergency department settings. We will change prescribing defaults for select short-acting opioid analgesics including immediate release oxycodone and hydrocodone as well as codeine and tramadol, including their co-formulations with acetaminophen. In a cluster-randomized trial of matched pairs of Montefiore Medical Center clinical sites, stratified by specialty and teaching status, we will evaluate the impact of this intervention on patient-level outcomes using 18 months of data (6 months pre-intervention and 12 months post-intervention).
Sponsors
Albert Einstein College of Medicine
Montefiore Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Clinical Site Inclusion Criteria: * Primary care clinic (internal medicine, family medicine, or urgent care) or emergency department within Montefiore Medical Center Patient Inclusion Criteria: * Received a new opioid analgesic prescription, defined as no opioid analgesic prescription in the preceding 6 months Patient
Exclusion criteria
* Cancer diagnosis code within the past 1 year
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Initial prescription <= 10 pills (y/n) | Through study completion (18 months) | Extracted from the electronic medical record |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Initial prescription morphine milligram equivalents | Through study completion (18 months) | Extracted from the electronic medical record |
| Opioid analgesic re-order (y/n) | Within 30 days after the initial prescription | Extracted from the electronic medical record |
| Total opioid analgesic pills prescribed, including re-orders | Within 30 days after the initial prescription | Extracted from the electronic medical record |
| Initial prescription number of pills | Through study completion (18 months) | Extracted from the electronic medical record |
| Outpatient visits | Within 30 days after the initial prescription | Extracted from the electronic medical record |
| Emergency department visits | Within 30 days after the initial prescription | Extracted from the electronic medical record |
| Hospitalizations | Within 30 days after the initial prescription | Extracted from the electronic medical record |
| Total morphine milligram equivalents prescribed, including re-orders | Within 30 days after the initial prescription | Extracted from the electronic medical record |
Outcome results
None listed