Evidence map›Paper›PMID 37357367›Full record

Trial reportJournal of hospital medicine2023

A behavioral intervention to promote use of multimodal pain medication for hospitalized patients: A randomized controlled trial.

Tasce Bongiovanni, Mark J Pletcher, Catherine Lau, Andrew Robinson, Elizabeth Lancaster, Li Zhang, Matthias Behrends, Elizabeth Wick, Andrew Auerbach

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of hospital medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Trial
  2. 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

9 authors at 1 institution in 1 country.

Tasce BongiovanniDepartment of Surgery, University of California San Francisco School of Medicine, San Francisco, California, USA.ORCID 0000-0003-4568-2087
Mark J PletcherDepartment of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, California, USA.
Catherine LauDivision of Hospital Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA.
Andrew RobinsonDepartment of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, California, USA.ORCID 0000-0002-1820-4621
Elizabeth LancasterDepartment of Surgery, University of California San Francisco School of Medicine, San Francisco, California, USA.
Li ZhangDepartment of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, California, USA.
Matthias BehrendsDepartment of Anesthesia, University of California San Francisco School of Medicine, San Francisco, California, USA.
Elizabeth WickDepartment of Surgery, University of California San Francisco School of Medicine, San Francisco, California, USA.
Andrew AuerbachDivision of Hospital Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA.ORCID 0000-0001-8440-0527
University of California, San Francisco · US

Funding

UCSF Learning Health System K12 Career Development ProgramK12HS026383 · AHRQ · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GONZALES, RALPH, SARKAR, URMIMALA · 2018 to 2022
$3.6M
Prolonged Use of Pain Medication Past the Postoperative Period in Older AdultsK23AG073523 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BONGIOVANNI, TASCE RIIKA SIMON · 2022 to 2025
$653k
AHRQ HHS K12 HS026383NIA NIH HHS K23 AG073523
6 · The paper itself

Abstract

backgroundThe use of nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce pain and has become a core strategy to decrease opioid use, but there is a lack of data to describe encouraging use when admitting patients using electronic health record systems.

objectiveAssess an electronic health record system to increase ordering of NSAIDs for hospitalized adults. DESIGNS, SETTINGS AND

participantsWe performed a cluster randomized controlled trial of clinicians admitting adult patients to a health system over a 9-month period. Clinicians were randomized to use a standard admission order set.

interventionClinicians in the intervention arm were required to actively order or decline NSAIDs; the control arm was shown the same order but without a required response. MAIN OUTCOME AND MEASURES: The primary outcome was NSAIDs ordered and administered by the first full hospital day. Secondary outcomes included pain scores and opioid prescribing.

resultsA total of 20,085 hospitalizations were included. Among these hospitalizations, patients had a mean age of 58 years, and a Charlson comorbidity score of 2.97, while 50% and 56% were female and White, respectively. Overall, 52% were admitted by a clinician randomized to the intervention arm. NSAIDs were ordered in 2267 (22%) interventions and 2093 (22%) control admissions (p = .10). Similarly, there were no statistical differences in NSAID administration, pain scores, or opioid prescribing. Average pain scores (0-5 scale) were 3.36 in the control group and 3.39 in the intervention group (p = .46). There were no differences in clinical harms. CONCLUSIONS AND RELEVANCE: Requiring an active decision to order an NSAID at admission had no demonstrable impact on NSAID ordering. Multicomponent interventions, perhaps with stronger decision support, may be necessary to encourage NSAID ordering.

Indexed as

Analgesics, OpioidPractice Patterns, Physicians'AdultAnti-Inflammatory Agents, Non-SteroidalFemaleHumansMaleMiddle AgedPainPatientsAnalgesics, OpioidAnti-Inflammatory Agents, Non-Steroidal

Identifiers

PMID37357367
PMCPMC10578203
OpenAlexW4382011736

What OpenQuestion holds

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Registered trials

None linked

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.