ArticleACR open rheumatology2019
Order From Chaos: An Initiative to Improve Opioid Prescribing in Rheumatology Using Lean A3.
Article in ACR open rheumatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed.
- Intervention Stage Completion and Behavioral Health Outcomes: An Integrated Behavioral Health and Primary Care Randomized Pragmatic Trial.Annals of family medicine · 2025Trial
- Implementation outcomes from a randomized, controlled trial of a strategy to improve integration of behavioral health and primary care services.BMC health services research · 2024Trial
- Effects of intervention stage completion in an integrated behavioral health and primary care randomized pragmatic intervention trial.medRxiv : the preprint server for health sciences · 2024Article
- Econometric evaluation of implementing a behavioral health integration intervention in primary care settings.Translational behavioral medicine · 2023Article
- Opioids for chronic pain management in patients with dialysis-dependent kidney failure.Nature reviews. Nephrology · 2022Review
- Supplementation-based hypoglycemia guidelines including donor breast milk reduce NICU admission.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveUse an established quality improvement method, Lean A3, to improve the process of opioid prescribing in an academic rheumatology ambulatory clinic.
methodsThis retrospective pre-postintervention analysis of rheumatology records included patients prescribed opioids at least once during the study period. Lean A3 was used to develop a Controlled Substance Visit Protocol to standardize eight recommended elements of the opioid prescribing workflow. Analyses included changes in the recommended workflow elements and changes in opioid prescribing volume.
resultsImprovements were observed in seven of the eight recommended elements. Patient education, including treatment agreements and consent forms (39% completion for both preimplementation) increased to 78% and 80%, respectively (
conclusionThe Lean A3 method is a successful quality improvement tool for improving and sustaining opioid prescribing within a single academic rheumatology clinic. This method has potential applicability to similar clinics interested in improving opioid prescribing.
Identifiers
What OpenQuestion holds
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.