Opioid Prescribing, Prescription Drug Misuse
Conditions
Keywords
opioids, prescribing, overprescribing, prescription drug monitoring programs, controlled substances
Brief summary
This study will test e-mails to encourage engagement with the Minnesota prescription monitoring program (PMP/PDMP) and will evaluate the effect of these e-mails on PMP/PDMP use and controlled substance prescribing.
Detailed description
Drug overdose deaths have skyrocketed in recent years, and many overdoses continue to involve prescribed medications like opioids and stimulants. At the same time, state prescription drug monitoring programs (PDMPs), which help clinicians prescribe these medications safely, remain underused. In Minnesota, 32% of opioid prescriptions are written by clinicians who do not use the PDMP. In many states, including Minnesota, policymakers have limited tools to raise PDMP use even though it is often required under state law. To address this policy dilemma, this study will test e-mails designed to facilitate PDMP use and evaluate their effects on PDMP use and controlled substance prescribing. This study will include a projected 7,126 physician and physician assistant prescribers of opioids and other controlled substances who lack active PDMP accounts, never query the PDMP, or query the PDMP infrequently relative to their prescribing volume. To generate evidence on clinician motivation for responding to encouragement, the study will randomly vary messaging to focus on legal requirements to use the PDMP vs. clinical benefits of the PDMP.
Interventions
BEHAVIORALPDMP Legal Mandate E-mail
E-mails highlighting the state's legal requirements to use the PDMP. There will be one initial email and one follow-up email one month later.
BEHAVIORALPDMP Clinical Benefit E-mail
E-mails highlighting the clinical benefits of having access to the PDMP and checking the PDMP before prescribing opioids. There will be one initial email and one follow-up email one month later.
Sponsors
Columbia University
University of Southern California
Bowdoin College
Abdul Latif Jameel Poverty Action Lab
Minnesota Management and Budget
Minnesota Board of Pharmacy
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Clinicians will be assigned at random to one of three arms: PDMP legal mandate e-mails, PDMP clinical benefit emails, or a control group.
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Minnesota physician or physician assistant * Controlled substance prescriber not following state requirements to maintain an active PDMP account, or opioid prescriber not searching the PDMP or infrequently searching the PDMP
Exclusion criteria
* No e-mail address available
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of PDMP Engagement | 2 months | An indicator for increased PDMP engagement during the 2-month period after the first e-mails were sent. It will indicate whether the level of engagement rose from the baseline level that resulted in the clinician's enrollment into the study. For clinicians who lacked an account, the outcome will indicate whether they created one; for clinicians with an inactive account, the outcome will indicate whether they reactivated it. For those who never searched, it will indicate any search, and for those who rarely searched, it will indicate whether their search rate rose. |
| Volume of Potentially Guideline-discordant Opioid Prescribing | 2 months | A composite of several measures of potentially guideline-discordant opioid prescribing. These will include: 1. Opioid co-prescriptions with other opioids 2. Opioid co-prescriptions with benzodiazepines 3. Opioid co-prescriptions with gabapentinoids 4. High daily opioid doses 5. Long-duration opioid prescriptions to opioid-naïve individuals |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORAdam Sacarny, PhD
Columbia University
PRINCIPAL_INVESTIGATORMireille Jacobson, PhD
University of Southern California
PRINCIPAL_INVESTIGATORTatyana Avilova, PhD
Bowdoin College
Outcome results
None listed