REDUCING INAPPROPRIATE PRESCRIPTION OPIOID PRESCRIBING AT HOSPITAL DISCHARGE

减少出院时不适当的阿片类药物处方

• 批准号: 10621186
• 负责人: Katherine E Watkins
• 金额: $ 59.09万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10621186
• 关键词: Address; Applied Research; Architecture; Area; Behavior; Behavioral; Behavioral Research; Benefits and Risks; Caring; Chronic; Clinical; Cluster randomized trial; Cognitive; Decision Making; Development; Discipline; Electronic Health Record; Electronic Mail; Feedback; Freedom; Geography; Goals; Guidelines; Health; Heroin; Hospitals; Incentives; Individual; Inpatients; Institution; Intervention; Judgment; Light; Link; Methodology; Modeling; Morphine; Motivation; Operative Surgical Procedures; Opiate Addiction; Opioid; Overdose; Pain management; Patients; Persons; Physicians; Postoperative Period; Provider; Psychologist; Public Health; Qualitative Evaluations; Recommendation; Research; Risk Factors; Sample Size; Social Psychology; Testing; Text; Thinking; Time; Uncertainty; Variant; Vendor; Work; behavior change; behavioral economics; behavioral health; comparative effectiveness; cost effective; design; experience; falls; health care settings; health economics; health goals; improved; incentive-based intervention; individual patient; insight; milligram; morphine equivalent; operation; opioid mortality; opioid overdose; opioid use; opioid use disorder; peer; prescription opioid; randomized trial; social; social norm; treatment as usual; usability

Enter the text here that is the new abstract information for your application. This section must be no longer than 30 lines of text. Project Summary/Abstract Physician opioid prescribing practices are a major upstream contributor to increases in chronic opioid use, opioid addiction and overdose deaths. Opioid prescribing after surgery is an important intervention target, as opioids are commonly overprescribed after surgery, post-operative opioid prescribing is a risk factor for chronic opioid use, and unused opioids prescribed for patients after surgery are an important reservoir of opioids available for misuse and diversion. The scientific premise of our study is research in social psychology and behavioral economics that suggest that people are strongly motivated by social approbation, which makes them want to adhere to prevailing social norms. In other settings, social norms have been used to successfully influence decision making, but have rarely been tested in the healthcare setting and have never been applied in the inpatient setting or with opioid prescribing across a range of conditions. We propose a cluster randomized trial to investigate the extent to which normative information, conveyed through “nudges” within the electronic health record (EHR), can change post-surgical opioid prescribing behavior, and whether the behavior change persists when the nudge is turned off. We will test and compare to usual care different ways of conveying and reinforcing social norms around opioid prescribing, including: (1) providing an injunctive norm at the time of prescribing (prescribing behavior compared to national guidelines); (2) providing the injunctive norm and cumulative feedback on prescribing behavior relative to the norm (i.e., whether or not the provider is a “top performer”) through a monthly email outside of the EHR. To our knowledge, no previous study has investigated the extent to which normative information, conveyed within the EHR, can change opioid prescribing behavior, an important public health goal. By examining the comparative effectiveness of different ways of conveying and reinforcing normative information for diverse practice areas, we also address a scientifically significant research question and advance applied research in social psychology and behavioral economics. With 23 hospitals located in diverse geographic settings and using a common EHR vendor (Epic), our clinical partner, Sutter Health, provides the institutional commitments and sample sizes to deploy and test the proposed nudges in a scientifically rigorous fashion.

在这里输入文本，即应用程序的新抽象信息。这部分的文本不能超过30行。

项目成果

Evaluating the effectiveness of email-based nudges to reduce postoperative opioid prescribing: study protocol of a randomised controlled trial.

评估基于电子邮件的午睡以减少术后阿片类药物处方的有效性：随机对照试验的研究方案。

• DOI: 10.1136/bmjopen-2022-061980
• 发表时间: 2022-09-19
• 期刊: BMJ OPEN
• 影响因子: 2.9
• 作者: Kirkegaard, Allison;Wagner, Zachary;Mariano, Louis T.;Martinez, Meghan C.;Yan, Xiaowei Sherry;Romanelli, Robert J.;Watkins, Katherine E.
• 通讯作者: Watkins, Katherine E.

Assessment of Postoperative Opioid Prescriptions Before and After Implementation of a Mandatory Prescription Drug Monitoring Program.

• DOI: 10.1001/jamahealthforum.2021.2924
• 发表时间: 2021-10
• 期刊: JAMA health forum
• 作者: Shenoy R;Wagner Z;Kirkegaard A;Romanelli RJ;Mudiganti S;Mariano L;Martinez M;Zanocco K;Watkins KE
• 通讯作者: Watkins KE