PRescribing INterventions for Chronic Pain Via the Electronic Health Record Study - Current Opioid-User Population (PRINCE)

University of Minnesota (UMN)

Status: Completed

Conditions: Opioid-use Disorder; Opioid Abuse; Opioid Use

Treatments: Behavioral: PMP Integration & Nudge; Behavioral: Choice Architecture Nudge

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04601480

R33DA046084 (U.S. NIH Grant/Contract)

STUDY00006522-1

Details and patient eligibility

About

The objective of this research is to assess the effects of electronic health record (EHR)-based decision support tools on primary care provider (PCP) decision-making around pain treatment and opioid prescribing. The decision support tools are informed by principles of "behavioral economics," whereby clinicians are "nudged," though never forced, towards guideline-concordant care.

Full description

To test the effects of these decision support tools for improving the quality of care for pain treatment, the investigators will implement a pragmatic clinic-randomized trial across the primary care clinics of Fairview Medical Group and University of Minnesota Physicians.

The study has two parallel components. The decision support tools to be tested will differ somewhat depending on whether a given patient is opioid-naïve, or whether a given patient is a current opioid-user. Four sets of analyses will be conducted separately: one for the opioid-naïve group using EHR data, one for the current opioid-user group using EHR data, one at the PCP-level using web survey data, and one at the PCP-level using MN Prescription Drug Monitoring Program (PDMP) data.

Enrollment: 309 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• All primary care providers from all of the Fairview and University of Minnesota Physicians study clinics

Exclusion criteria

• Primary care providers who work less than 20% full time equivalent (FTE)

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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309 participants in 4 patient groups

Care as Usual

No Intervention group

Description:

Clinics assigned to this arm will continue to care for the patients as usual in regards to opioid prescribing.

Choice Architecture Nudge

Experimental group

Description:

Clinics in this arm will receive the choice architecture nudge intervention.

Treatment:

Behavioral: Choice Architecture Nudge

PMP Integration & Nudge

Experimental group

Description:

Clinics in this arm will receive the Prescription Drug Monitoring (PMP) Integration \& Nudge intervention.

Treatment:

Behavioral: PMP Integration & Nudge

Choice Architecture Nudge + PMP Integration & Nudge

Experimental group

Description:

Clinics in this arm will receive both the choice architecture nudge and prescription drug monitoring (PMP) integration \& nudge interventions.

Treatment:

Behavioral: Choice Architecture Nudge

Behavioral: PMP Integration & Nudge