Pain Clinical Trial
Official title:
Assessing Opioid Care Practices Using CPV Patient Simulation Modules to Improve Alignment With CDC Guidelines
This study will test the quality of opioid-related physician care decisions using a patient-simulation based measurement and feedback approach that combines multiple-choice care decisions with real-time, personalized scoring and feedback. The cases and feedback have been designed to align with the latest CDC opioid guidelines. The study will also measure the impact of gaming-inspired competition and motivation, including a weekly leaderboard, to improve evidence-based care decisions. The quality of care decisions will be measured in the simulations and in a multiple-choice assessment administered before and after the patient simulations.
Primary care providers (PCPs) are often on the front lines of helping patients manage acute
and chronic pain. These pain management decisions have become especially important in light
of the national opioid crisis that has seen an unsettling rise in opioid dependency,
over-doses and fatalities. The Centers for Disease Control has developed specific
evidence-based guidelines to help clinicians make more informed decisions about appropriate
use of opioids as well as identifying and managing patients at risk for opioid-use disorder
and overdose.
The investigators' previous work has shown that patient simulations can rapidly and reliably
measure unwarranted practice variation among providers. In addition, published work shows
that patient simulations, when administered serially and combined with customized feedback on
improvement opportunities can reduce practice variation and improve performance on
patient-level quality measures. Given the challenge of the current opioid crisis and the
large scope of unwarranted variation in medical practice, there is a need for scalable
approaches to measure care decisions, provide feedback on improvement opportunities and
benchmark performance to peers.
This study seeks to evaluate the impact of personalized measurement and feedback on
evidence-based care decisions made by primary care providers across the country concerning
opioid care. The study, a prospective cohort trial, will enroll primary care physicians
(PCPs) practicing in the U.S. Upon enrollment, eligible providers will be asked to complete a
questionnaire detailing their practice and professional background. They will then be asked
to complete the following:
Pretest: Pre-project, participants will take a multiple-choice assessment test. These
assessments measure CDC Opioid Guidelines knowledge and adherence. Study administrators will
randomize half of providers to take Assessment A pre-intervention, and half to take
Assessment B pre-intervention, and have attempted to make these two assessments of equal
difficulty.
Intervention: All providers will then care for 1 online CPV QualityIQ patient simulation each
week over the course of 6 weeks. The simulated patients will be adults aged 18-75 and present
with clinical conditions commonly seen by PCPs, such as chronic or acute pain, for whom
opioids are currently in use or may be considered. In the patient simulations, participants
will make work-up, diagnostic and treatment decisions relevant to the patient's pain
management and will receive real-time feedback on how those decisions align with the CDC
recommendations. Each week, participants will receive an email notification with their case
score from the previous week, how their care compares to their PCP peers, and a link their
new case to be completed.
Posttest: Recruits will take the remaining assessment as described above after completion of
the intervention.
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