Addressing Origins of the Opioid Epidemic by Improving Prescribing for Opioid-Naive Patients
| Status: | Recruiting |
|---|---|
| Conditions: | Psychiatric, Gastrointestinal |
| Therapuetic Areas: | Gastroenterology, Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 89 |
| Updated: | 2/17/2019 |
| Start Date: | February 1, 2018 |
| End Date: | December 31, 2019 |
| Contact: | Jessica S Ancker, PhD, MPH |
| Email: | jsa7002@med.cornell.edu |
| Phone: | 646-962-9404 |
Risk of long-term opioid dependence increases with initial opioid dose/duration, but despite
recent CDC (Centers for Disease Control and Prevention)-endorsed minimum doses for initial
opioid prescription, primary care providers are likely to overprescribe. In this quality
improvement project, primary care departments at Weill Cornell and the Institute for Family
Health (NYC-based FQHC) will implement an unobtrusive "nudge" in their electronic prescribing
software to promote the CDC (Centers for Disease Control and Prevention)-endorsed low doses
for all opioids. In the evaluation, we will employ a quasi-experimental design with rigorous
interrupted time series analysis methods to assess the effect of the "nudge" on prescribing
rates. The analysis will be performed at the provider level, with deidentified physician data
and a limited data set (fully deidentified except for date of prescription) of patient-level
data.
recent CDC (Centers for Disease Control and Prevention)-endorsed minimum doses for initial
opioid prescription, primary care providers are likely to overprescribe. In this quality
improvement project, primary care departments at Weill Cornell and the Institute for Family
Health (NYC-based FQHC) will implement an unobtrusive "nudge" in their electronic prescribing
software to promote the CDC (Centers for Disease Control and Prevention)-endorsed low doses
for all opioids. In the evaluation, we will employ a quasi-experimental design with rigorous
interrupted time series analysis methods to assess the effect of the "nudge" on prescribing
rates. The analysis will be performed at the provider level, with deidentified physician data
and a limited data set (fully deidentified except for date of prescription) of patient-level
data.
The two participating institutions, WCMC (Weill Cornell Medical College) and IFH (Institute
for Family Health), intend to redesign the e-prescribing interface to create a minor "nudge"
to encourage prescribers to prescribe the minimum dose set by the 2016 CDC guideline for
opioid-naive patients in 2018. The change to the e-prescribing system is that after a
prescriber chooses the drug they wish to prescribe, the minimum recommended dosage from the
CDC guidelines will be displayed. The prescriber can choose to change the dosage by
overwriting in the field box. The changes to the prescriber system will be implemented at two
Weill Cornell clinical organizations: Weill Cornell Internal Medicine Associates (WCIMA) and
Weill Cornell Medical Associates (CMA), and at all locations at our collaborating institution
IFH (Institute for Family Health). Weill Cornell and IFH will provide data for the analysis,
which will be conducted by the co-investigators on this protocol. The project will assess
data pre- and post- implementation to study prescribing patterns.
for Family Health), intend to redesign the e-prescribing interface to create a minor "nudge"
to encourage prescribers to prescribe the minimum dose set by the 2016 CDC guideline for
opioid-naive patients in 2018. The change to the e-prescribing system is that after a
prescriber chooses the drug they wish to prescribe, the minimum recommended dosage from the
CDC guidelines will be displayed. The prescriber can choose to change the dosage by
overwriting in the field box. The changes to the prescriber system will be implemented at two
Weill Cornell clinical organizations: Weill Cornell Internal Medicine Associates (WCIMA) and
Weill Cornell Medical Associates (CMA), and at all locations at our collaborating institution
IFH (Institute for Family Health). Weill Cornell and IFH will provide data for the analysis,
which will be conducted by the co-investigators on this protocol. The project will assess
data pre- and post- implementation to study prescribing patterns.
Inclusion Criteria:
- Prescriber - practices internal medicine at WCMC OR family practice at IFH and has
prescribed opioids since 11/1/2015
Exclusion Criteria:
- Prescriber - has not written any opioid prescriptions during the study period
We found this trial at
2
sites
New York, New York
Principal Investigator: Sarah C Nosal, MD
Phone: 212-659-1406
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445 E 69th St
New York, New York 10021
New York, New York 10021
(212) 746-1067
Phone: 646-962-9404
Weill Medical College of Cornell University Founded in 1898, and affiliated with what is now...
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