Evidence map›Paper›PMID 29678969›Full record

Trial reportBMJ open2018

Reducing the default dispense quantity for new opioid analgesic prescriptions: study protocol for a cluster randomised controlled trial.

Marcus A Bachhuber, Denis Nash, William N Southern, Moonseong Heo, Matthew Berger, Mark Schepis, Chinazo O Cunningham

2 registry-linked trialsOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03003832 nacompletednot on this map

A Cluster-randomized Trial of Modifying Electronic Health Record Defaults to Reduce the Prescribed Quantity of Opioid Analgesics in Primary Care and Emergency Department Settings

TypeinterventionalSponsorMontefiore Medical CenterRan2016 to 2018Enrolled15,000ConditionsAcute PainArmsChange in electronic health record default for new opioid analgesic prescriptions
NCT04944225 naunknown statusnot on this mapstarted 2024, after this paper: background citation

Implementation of a Multi-faceted Opioid-Use Reduction Strategy for South Western Ontario: A Pragmatic Stepped-Wedge Cluster Randomized Trial

TypeinterventionalSponsorLondon Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph'sRan2024 to 2025Enrolled100,000ConditionsOpioid UseArmsOpioid Reduction Strategy
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Marcus A BachhuberDivision of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, New York City, New York, USA.ORCID 0000-0002-5610-8382
Denis NashInstitute for Implementation Science in Population Health, City University of New York (CUNY), New York City, New York, USA.
William N SouthernDivision of Hospital Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, New York City, New York, USA.
Moonseong HeoDepartment of Epidemiology and Population Health, Montefiore Medical Center/Albert Einstein College of Medicine, New York City, New York, USA.
Matthew BergerDivision of Hospital Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, New York City, New York, USA.
Mark SchepisMontefiore Information Technology, Montefiore Medical Center, New York City, New York, USA.
Chinazo O CunninghamDivision of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, New York City, New York, USA.
Albert Einstein College of Medicine · USCity University of New York · USMontefiore Medical Center · US

Funding

Patient and Population Health Outcomes Research SWGP30AI124414 · NIAID · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI Vilma Gabbay · 2017 to 2026
$28.3M
Core-010UL1TR001073 · NCATS · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI KELLER, MARLA J, SHAMOON, HARRY · 2013 to 2017
$21.3M
Utilization of health services after engagement with opioid use disorder (OUD) treatment provider by individuals with and without post-traumatic stress disorderP30DA040500 · NIDA · WEILL MEDICAL COLL OF CORNELL UNIV · PI ZACHARY Franklin MEISEL · 2015 to 2026
$20.7M
Mentoring researchers on drug abuse and HIVK24DA036955 · NIDA · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI CUNNINGHAM, CHINAZO · 2014 to 2019
$911k
Leveraging the electronic health record to reduce opioid analgesic prescriptionsK08DA043050 · NIDA · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI BACHHUBER, MARCUS A · 2017 to 2018
$223k
NCATS NIH HHS UL1 TR001073NIAID NIH HHS P30 AI124414NIDA NIH HHS K08 DA043050NIDA NIH HHS K24 DA036955NIDA NIH HHS P30 DA040500
6 · The paper itself

Abstract

introductionAs opioid analgesic consumption has grown, so have opioid use disorder and opioid-related overdoses. Reducing the quantity of opioid analgesics prescribed for acute non-cancer pain can potentially reduce risks to the individual receiving the prescription and to others who might unintentionally or intentionally consume any leftover tablets. Reducing the default dispense quantity for new opioid analgesic prescriptions in the electronic health record (EHR) is a promising intervention to reduce prescribing. METHODS AND ANALYSIS: This study is a prospective cluster randomised controlled trial with two parallel arms. Primary care sites (n=32) and emergency departments (n=4) will be randomised in matched pairs to either a modification of the EHR so that new opioid analgesic prescriptions default to a dispense quantity of 10 tablets (intervention) or to no EHR change (control). The dispense quantity will remain fully modifiable by providers in both arms. From 6 months preintervention to 18 months postintervention, patient-level data will be analysed (ie, the patient is the unit of inference). Patient eligibility criteria are: (A) received a new opioid analgesic prescription, defined as no other opioid analgesic prescription in the prior 6 months; (B) age ≥18 years; and (C) no cancer diagnosis within 1 year prior to the new opioid analgesic prescription. The primary outcome will be the quantity of opioid analgesics prescribed in the initial prescription. Secondary outcomes will include opioid analgesic reorders and health service utilisation within 30 days after the initial prescription. Outcomes will be compared between study arms using a difference-in-differences analysis. ETHICS AND DISSEMINATION: This study has been approved by the Montefiore Medical Center/Albert Einstein College of Medicine Institutional Review Board with a waiver of informed consent (2016-6036) and is registered on ClinicalTrials.gov (NCT03003832, 6 December 2016). Findings will be disseminated through publication, conferences and meetings with health system leaders. TRIAL REGISTRATION NUMBER: NCT03003832; Pre-results.

Indexed as

Analgesics, OpioidDrug OverdoseDrug PrescriptionsElectronic Health RecordsEmergency Service, HospitalHumansNew York CityOpioid-Related DisordersPractice Patterns, Physicians'Primary Health CareProspective StudiesAnalgesics, Opioidacute paindefaultelectronic health recordopioid analgesicspain management

Identifiers

PMID29678969
PMCPMC5914704
OpenAlexW2800199785

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.