EMR Defaults to Nudge Opioid Prescribing

Pain, Acute Clinical Trial

Official title:

Effect of Default Electronic Health Record Settings on Clinician Opioid Prescribing Patterns in Emergency Departments

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04155229
• Other study ID #: EMRdefaults
• Status: Completed
• Phase: N/A
• Start date: October 3, 2016
• Est. completion date: September 3, 2017

Study information

• Verified date: November 2019
• Source: University of California, San Francisco
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The investigators conducted a prospective, block-randomized study to determine whether and to what extent changes in the default settings in the electronic medical record (EMR) affect opioid prescriptions for patients discharged from emergency departments (EDs).

Description:

In two large, urban emergency departments, we randomly altered the pre-populated dispense quantities of discharge prescriptions for commonly-prescribed opioids over a series of five 4-week blocks. These changes were made without announcement, and providers were not informed of the study itself.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 104
• Est. completion date: September 3, 2017
• Est. primary completion date: September 3, 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Discharge prescription from emergency for study drug: hydrocodone/acetaminophen, oxycodone, or oxycodone/acetaminophen.

Exclusion Criteria:

• none

Related Conditions & MeSH terms

• Acute Pain
• Opioid Use, Unspecified
• Pain, Acute

Intervention

Other:
• Default settings for opioid prescriptions (acetaminophen/hydrocodone, oxycodone, acetaminophen/oxycodone)
For each of the arms, the investigators modified the default setting for the dispense quantity of study opioids on the electronic medical record settings for discharge prescriptions. Study drugs include acetaminophen 325mg + hydrocodone 5mg, acetaminophen 325mg + hydrocodone 7.5mg, acetaminophen 325mg + hydrocodone 10mg, oxycodone 5mg, acetaminophen 325mg + oxycodone 5mg, acetaminophen 325mg + oxycodone 10mg.

Locations

Country	Name	City	State
n/a

Sponsors (2)

Lead Sponsor	Collaborator
University of California, San Francisco	National Center for Advancing Translational Science (NCATS)

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Dispense quantity of prescribed opioids	The dispense quantity of prescribed study drugs was collected from the electronic medical record at each site. The mean and median quantities per prescription according to each study arm were compared.	Through study completion, approximately 340 days
Secondary	Proportion =12	The dispense quantity of study drugs was collected from the electronic medical record at each site. The proportion of prescriptions at 12 or fewer tablets was compared across study arms.	Through study completion, approximately 340 days
Secondary	Proportion at default setting	The dispense quantity of study drugs was collected from the electronic medical record at each site. The proportion of prescriptions written for the given default setting was compared across treatment arms.	Through study completion, approximately 340 days