Peer Comparison Feedback on Opioid Prescribing

Study Overview
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Brief Summary
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We aim to determine if descriptive normative feedback of peer prescribing reduces opioid analgesic prescribing by emergency medicine providers

Detailed Description
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State-based Prescription Drug Monitoring Programs (PDMPs) are being implemented to reduce prescription drug abuse and diversion. On August 24, 2016, Pennsylvania initiated its mandated PDMP. In prior research, we found that ED providers reduced opioid prescribing by 17% immediately after PDMP went live. Still, there is variability between providers in the frequency of opioid prescribing even after PDMP initiation. Changing clinician prescribing behavior is difficult, but recent research has shown that using peer comparisons can assist behavior change (Meeker D et al., JAMA, 2016). In this study, we will randomize a convenience sample of ED providers to receive either their opioid prescribing history data with peer comparative data or without peer comparative data. We will examine the effect on immediate perceived norms as well as impact on opioid prescribing in the subsequent 3 months. Results could inform behavioral feedback to alter clinician prescribing behaviors

Official Title
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Effect of Peer Comparison Feedback on Opioid Prescribing by Emergency Medicine Providers

Conditions
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Opioid Use

Intervention / Treatment
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* Behavioral: Personal Feedback
* Behavioral: Peer Normative Comparison Feedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Emergency medicine provider Writes 10 or more opioid prescriptions per month (on average) Exclusion Criteria: none

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Normative Peer Comparison<br>One-time summary report of 14-month individual history of opioid prescribing WITH comparisons to (a) other providers at their site and (2) other providers at 15 ED sites with similar prescribing | Behavioral: Peer Normative Comparison Feedback<br>* One-time summary report of their individual history of opioid prescribing over the past 14 months WITH comparisons to (a) other providers at their site and (2) other providers at all 15 ED sites with similar prescribing<br>|
| Active Comparator: Control Feedback<br>One-time summary report of their individual history of opioid prescribing | Behavioral: Personal Feedback<br>* One-time summary report of their individual history of opioid prescribing over the past 14 months<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Normative beliefs | How much, relative to other emergency providers, do they prescribe opioids? | Pre-post intervention | 
| Number of opioid prescriptions per month | Number of opioid prescriptions written | 3-months pre-intervention to 3-months post intervention |