Clinical Decision Support for Safety of Opioid Transitions

University of Colorado Denver (CU Denver)

Status: Not yet enrolling

Conditions: Medication Abuse; Harm Reduction

Treatments: Other: Opioid Transitions Clinical Decision Support (CDS)

Study type: Observational

Funder types: Other; NIH

Identifiers

NCT06527040

R61DA057610 (U.S. NIH Grant/Contract)

24-1192

Details and patient eligibility

About

The objective of this study is to evaluate the impact of clinical decision support (CDS) alert to notify providers when the opioid prescription being written will result in the patient transitioning into a new phase of opioid therapy. The 2022 CDC clinical practice guideline for prescribing opioids for pain recommends providers reassess patient pain as well as the risks and benefits of opioid therapy before patients transition from acute to subacute treatment (1 month of opioid analgesics) and when patients transition from subacute to chronic opioid treatment (3 months). This study will evaluate a clinical decision support tool identifying patients who will be transitioning between phases as a result of an opioid prescription and suggest a review of patient pain and goals. Primary care providers will be randomized at the clinic location to a control arm or intervention arm. The control arm will not be notified that the prescription transitions the patient to a new phase but will have access to the same patient pain scales and information. The intervention arm will receive a notification of the transition and suggest review of patient needs and encourage documentation. Opioid transition orders and outcomes of patients will be examined based on medical records data collected during routine care.

Enrollment: 200,000 estimated patients

Sex: All

Ages: 12 to 89 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria: Any primary care encounter where an opioid is prescribed that transitions the patient to a different stage of opioid therapy (acute to subacute after 1 month of opioids; subacute to chronic after 3 months of an opioid)

Exclusion Criteria:

• Patients <12 and >89
• Patients with active cancer diagnosis in last 1 year
• Patients with hospice care/palliative care order
• Patients with sickle cell disease diagnosis

Trial design

200,000 participants in 2 patient groups

Usual Care

Description:

Control group of contemporary encounters where clinical decision support alert is not active. Usual care.

Clinical Decision Support (CDS): Opioid transition alert

Description:

Encounters where the opioid transition clinical decision support (CDS) alert fired. CDS logic is programmed to fire the alert when a provider places an order for an opioid that will transition the patient from acute to subacute opioid therapy (at 30 days) or from subacute to chronic opioid therapy (at 90 days).

Treatment:

Other: Opioid Transitions Clinical Decision Support (CDS)