Application of Economics & Social Psychology to Improve Opioid Prescribing Safety (AESOPS): R21 Pilot Phase
| Status: | Enrolling by invitation |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/6/2019 |
| Start Date: | March 25, 2019 |
| End Date: | August 2019 |
There is a lack of evidence that long-term opioid use offers benefit for noncancer pain and
an abundance of evidence of harm. The objective of the R21 pilot phase of the Application of
Economics & Social psychology to improve Opioid Prescribing Safety (AESOPS) is to develop and
test novel behavioral nudges to encourage adherence to pain and CDC guidelines for opioid
prescribing for persons with noncancer pain. Interventions will leverage the electronic
health record (EHR): Accountable Justification alerts triggered by discordant prescriptions
that populate the note with provider's rationale for guideline exceptions and Active Choice
(SmartSet) that are triggered by EHR workflow containing exclusively guideline concordant
choices. Clinicians will also receive audit and feedback on their performance during the
prior quarter as well as in comparison to other clinicians on CDC quality measures.
an abundance of evidence of harm. The objective of the R21 pilot phase of the Application of
Economics & Social psychology to improve Opioid Prescribing Safety (AESOPS) is to develop and
test novel behavioral nudges to encourage adherence to pain and CDC guidelines for opioid
prescribing for persons with noncancer pain. Interventions will leverage the electronic
health record (EHR): Accountable Justification alerts triggered by discordant prescriptions
that populate the note with provider's rationale for guideline exceptions and Active Choice
(SmartSet) that are triggered by EHR workflow containing exclusively guideline concordant
choices. Clinicians will also receive audit and feedback on their performance during the
prior quarter as well as in comparison to other clinicians on CDC quality measures.
There is a lack of evidence that long-term opioid use offers benefit for noncancer pain and
an abundance of evidence of harm. In 2017, the Centers for Disease Control and Prevention
(CDC) issued the "CDC Guideline for Prescribing Opioids for Chronic Pain" to encourage safe
and effective alternatives to opioids, discontinuation of opioids when patients do not resume
normal activities and prudent dosing strategies. However, poor guideline adherence is a
general concern and may impede uptake. Our prior studies have used insights from behavioral
economics and social psychology to increase guideline adherence. The objective of the R21
pilot phase of the Application of Economics & Social psychology to improve Opioid Prescribing
Safety (AESOPS) is to develop and test the following novel behavioral nudges to encourage
adherence to pain and CDC guidelines for opioid prescribing for persons with noncancer pain:
1) Accountable Justification alert will have clinicians enter a brief statement justifying
their opioid prescription for new orders or refills. The note will then be added to the
patient's medical record, 2) The Active Choice (SmartSet) alert will encourage clinicians to
engage in a taper discussion with the patient and either begin a taper or justify a reason
for continuing medication, 3) Audit and Feedback will provide clinicians with aggregate data
on their performance relative to top-performing peers on CDC measures of interest. This
information will be reported back to the clinician by mail, email or within the electronic
health record. Peer comparison encourages clinician to follow the lead of top performers, as
we often follow the lead of others similar to ourselves.
an abundance of evidence of harm. In 2017, the Centers for Disease Control and Prevention
(CDC) issued the "CDC Guideline for Prescribing Opioids for Chronic Pain" to encourage safe
and effective alternatives to opioids, discontinuation of opioids when patients do not resume
normal activities and prudent dosing strategies. However, poor guideline adherence is a
general concern and may impede uptake. Our prior studies have used insights from behavioral
economics and social psychology to increase guideline adherence. The objective of the R21
pilot phase of the Application of Economics & Social psychology to improve Opioid Prescribing
Safety (AESOPS) is to develop and test the following novel behavioral nudges to encourage
adherence to pain and CDC guidelines for opioid prescribing for persons with noncancer pain:
1) Accountable Justification alert will have clinicians enter a brief statement justifying
their opioid prescription for new orders or refills. The note will then be added to the
patient's medical record, 2) The Active Choice (SmartSet) alert will encourage clinicians to
engage in a taper discussion with the patient and either begin a taper or justify a reason
for continuing medication, 3) Audit and Feedback will provide clinicians with aggregate data
on their performance relative to top-performing peers on CDC measures of interest. This
information will be reported back to the clinician by mail, email or within the electronic
health record. Peer comparison encourages clinician to follow the lead of top performers, as
we often follow the lead of others similar to ourselves.
Inclusion Criteria:
- NM clinic that sees patients ≥ 18 years old whose leadership agrees to participate
Exclusion Criteria:
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