Opioids Clinical Trial
Official title:
Safe Opioid Prescription Practice for Patients Discharged From Trauma Services With a Prescription for Opioids
Using a quasi-experimental design the investigators will compare the effect of adopting and implementing a Safe Opioid Prescription Practice (SOPP) protocol within a Level 1 trauma service team compared to a Level 1 trauma service team implementing standard care.
Prescribing opioids to injured patients who are discharged from an inpatient trauma
admission is almost ubiquitous; however up to 26% of patients prescribed opioids for chronic
pain abuse them leaving them at an increased risk of overdose and overdose fatality.
Addressing this problem through an institutional level approach involving both patients and
providers, including changes in physician prescription behaviors and directly intervening
with the patients to increase knowledge of risks of opioid misuse and overdose, affords us
the best opportunity to address this escalating public health concern.
Using a quasi-experimental design the investigators will compare the effect of adopting and
implementing a Safe Opioid Prescription Practice (SOPP) protocol within a Level 1 trauma
service team compared to a Level 1 trauma service team implementing standard care. Providers
at both sites will complete web-based surveys to assess baseline knowledge, attitudes and
barriers related to safe prescription practices. The intervention site will complete
technical assistance activities to lead to the adoption and implementation of a SOPP
protocol. The control site will continue to offer standard care to trauma patients
throughout all phases. To measure institutional level changes, chart reviews will be
conducted at both sites using a blinded medical review of discharged trauma service patients
at baseline, early implementation, implementation and maintenance phases. To measure patient
level changes, the investigators will assess patient perception of the discharge experience
at both sites during the adoption phase (Cohort 1=100); implementation phase (Cohort 2=100)
and maintenance phase (Cohort 3=100) via telephone interview within 7 days post discharge.
Three month interviews will also be conducted with Cohort 2 to assess patient opioid usage,
pain management strategies and Naloxone usage among Cohort 2. The aims of the proposed
research study are to 1) examine and measure the adoption, implementation and maintenance of
the SOPP protocol in the intervention site compared to standard care site and 2) to assess
patient level outcomes of the SOPP protocol. The secondary aim of this study is to assess
the effect the SOPP protocol on provider prescribing practices comparing the average dosage
(in morphine milligram equivalents) and duration of dose from the chart review at baseline
to the early implementation, implementation and maintenance phases of the study. The
findings from this study will allow us to better understand the translation of a safe opioid
prescription practice and has the potential to impact best practices for patient discharge
within Level 1 trauma centers.
;
Allocation: Non-Randomized, Intervention Model: Single Group Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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