Opioid Prescribing
Conditions
Keywords
Surgery
Brief summary
The objective of this project is to leverage the Michigan Surgical Quality Collaborative's (MSQC) existing network and surgeon performance feedback platform to improve opioid prescribing practices for surgeons within the network found to be prescribing in a manner discordant with published guidelines and to inform best practices for future surgical quality improvement initiatives. The study is being completed to learn more about the effectiveness, feasibility, and acceptability and that the goal is both to evaluate how effective this intervention and mechanism are for changing surgeon opioid prescribing behavior and to inform best practices for future quality initiatives. The study hypothesizes that provider-level feedback will allow clinicians to tailor postoperative prescribing more closely to patient consumption, and reduce excess postoperative prescribing. The cohort of surgeons which have been identified as outliers by the Michigan Surgical Quality Collaborative (MSQC) will be be invited to participate in this trial. The study team will send surgeons belonging to sites that signed the Exhibit B-1 form the provider-level push notifications (98 participants). In this study de-identified prescribing data will also be analyzed for sites that do not sign the Exhibit B-1 form (105 participants). The study team will approach 98 surgeons receiving the provider-level push notifications in one wave.
Interventions
BEHAVIORALPush reports
Surgeons in the experimental arm will receive provider-level push report notifications through an email displaying their personal prescribing performance compared to Michigan Opioid Prescribing Engagement Network (OPEN) prescribing guidelines and their de-identified peers. The push report will also include a link to the secure MSQC data platform that displays more information about the case so the surgeon can further investigate prescribing information. The email will also contain contact information for the study team so as to help any surgeons troubleshoot, learn more, request to stop receiving reports, etc.
Sponsors
National Institute on Drug Abuse (NIDA)
University of Michigan
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Surgeons already participating in and sharing data with the Michigan Surgical Quality Collaborative (MSQC) who perform procedures of interest * Surgeons within MSQC who have median prescribing \> 1 pill equivalents over the published recommendation * Surgeons within MSQC who perform surgeries at a hospital that have agreed to participate in this research
Exclusion criteria
* Surgeons not identified in the MSQC data as having a valid National Provider Identifier (NPI)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Opioid Prescribed Following the Intervention | up to 5 months from enrollment | Oral morphine equivalents prescribed adjusted for surgery type as reported through MSQC data. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Provider-level Push Report Notifications Push reports will be sent via using a secure email client. The email will be sent to the email address provided to the study team by the surgeon or site.
Push reports: Surgeons in the experimental arm will receive provider-level push report notifications through an email displaying their personal prescribing performance compared to Michigan Opioid Prescribing Engagement Network (OPEN) prescribing guidelines and their de-identified peers.
The push report will also include a link to the secure MSQC data platform that displays more information about the case so the surgeon can further investigate prescribing information. The email will also contain contact information for the study team so as to help any surgeons troubleshoot, learn more, request to stop receiving reports, etc. | 95 |
| No Intervention Sites who did not sign Exhibit B-1. | 122 |
| Total | 217 |
Baseline characteristics
| Characteristic | — | Total | Provider-level Push Report Notifications | No Intervention |
|---|---|---|---|---|
| Age, Continuous | — Years | — | — | — |
| Prescribing Practices | — | 66.4 Morphine Milligram Equivalents (MME) STANDARD_DEVIATION 55.21 | 68.5 Morphine Milligram Equivalents (MME) STANDARD_DEVIATION 56.87 | 64.3 Morphine Milligram Equivalents (MME) STANDARD_DEVIATION 53.42 |
| Race and Ethnicity Not Collected | — | 0 Participants | — | — |
| Region of Enrollment United States | — | 217 Participants | 95 Participants | 122 Participants |
| Sex: Female, Male Female | — | 0 Participants | — | — |
| Sex: Female, Male Male | — | 0 Participants | — | — |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 95 | 0 / 122 |
| other Total, other adverse events | 0 / 95 | 0 / 122 |
| serious Total, serious adverse events | 0 / 95 | 0 / 122 |
Outcome results
Primary
Change in Opioid Prescribed Following the Intervention
Oral morphine equivalents prescribed adjusted for surgery type as reported through MSQC data.
Time frame: up to 5 months from enrollment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Provider-level Push Report Notifications | Change in Opioid Prescribed Following the Intervention | 62.0 Morphine Milligram Equivalents (MME) | Standard Deviation 47.24 |
| No Intervention | Change in Opioid Prescribed Following the Intervention | 58.8 Morphine Milligram Equivalents (MME) | Standard Deviation 46.78 |
p-value: 0.01Two-part regression model