Postoperative Nudges to Reduce Opioid Prescribing (POST-OP)
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About
This study tests the effectiveness of two email-based behavioral nudges, one based on peer behavior and one based on best practice guidelines, in reducing excessive opioid prescriptions after surgery. It will be conducted in three surgical specialties (general surgery, orthopedic surgery, and obstetric/gynecological surgery) at 19 hospitals within one healthcare system. These specialties will each be randomized to a control group or one of two nudge groups. Each month for one year, surgeons in the nudge groups will receive emails comparing their opioid prescribing either to their peers' prescribing or to prescribing guidelines. Both types of email-based nudges are expected to reduce opioid prescribing after surgery.
Enrollment
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Inclusion and exclusion criteria
The nudges that a surgeon in either intervention arm will receive are based on that surgeon's eligible discharge opioid prescriptions in the previous month. Eligible prescriptions meet all of the following criteria:
- the patient is at least 18 years old at the date of surgery
- the patient is discharged to their home
- the surgical procedure has an applicable post-operative opioid prescribing guideline
- the surgical procedure is the only surgical procedure performed during the patient's hospital stay
- the prescription is for an opioid taken orally (tablets, capsules, or liquid solution)
To avoid contamination between the intervention arms, surgeons who operate across multiple surgical specialties (defined as surgeons who performed less than 90% of their total procedures in one specialty between June 2020 and May 2021) will not be eligible.
Trial design
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Interventional model
Masking
640 participants in 3 patient groups
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Data sourced from clinicaltrials.gov
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