Clinical trial NCT02790476: Behavioral Insights to Encourage Judicious Prescribing of Opioids
Official title: Use of Behavioral Insights to Encourage Judicious Prescribing of Opioids
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Substance-Related Disorders
Keywords: Safe
Prescribing
Opioids
Lead sponsor: University of Southern California
Sponsor class: OTHER
First posted: 2016-06-06
Enrollment: 851
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: In collaboration with the San Diego Medical Examiner's Office and the State of California's controlled Substance Utilization Review and Evaluation System (CURES), the investigators propose to review opioid poisonings over the past 12 months and will send letters to prescribers in California when at least one of the provider's prescription(s) was filled by a patient who died of an opioid poisoning in San Diego County. The letters will be non-judgmental and factual, explaining that a patient of the provider who was being treated with prescription narcotics died of an opioid poisoning. The letter will also encourage judicious prescribing including use of the CURES system before prescribing. The investigators will evaluate physician prescribing practices over 24 months 12 months pre- and 12 months post-letter using data from the CURES database. The investigators' hypothesis is that letters will make the risk of opioids more cognitively available and that physicians will respond by prescribing opioids more carefully. This will result in fewer deaths due to misuse and more frequent use of the CURES system.


Eligibility criteria: The investigators will not be enrolling subjects. This is an evaluation of a public health intervention involving sending prescriber's factual and nonjudgmental letters, signed by the County Medical Examiner, that would state that a patient the provider had treated with controlled substances died of an opioid poisoning.

Inclusion Criteria:

* Prescribers in California for whom at least one of their prescription(s) was filled by a patient who died of an opioid poisoning in San Diego County

Exclusion Criteria:

* Prescriber is licensed outside the State of California and does not hold a California license, but the prescription was filled in California
* The prescriber does not have a CURES report on record
* The prescriber has issued only one opioid prescription in the last 12 months since the time of the deceased death (and the prescription was to the deceased)
* Prescribers with unknown Drug Enforcement Agency number

Primary outcomes:
measure: Average Change Over Time in Dispensed Narcotics
timeFrame: 12 months
measure: Number of Opioid Prescriptions for > 90 Morphine Milligram Equivalent (MME) and ≥ 50 MME
timeFrame: 12 months
measure: Number of Opioid and Benzodiazepine Co-prescriptions
timeFrame: 12 months
Secondary outcomes:
measure: Frequency of CURES Use
timeFrame: 12 months
measure: Number of "New Start" Prescriptions
timeFrame: 12 months
Other outcomes:
Locations:
city: San Diego
country: United States
facility: San Diego County Medical Examiner's Office
state: California
Study officials:
affiliation: University of Southern California
name: Jason Doctor, PhD
role: PRINCIPAL_INVESTIGATOR
References: