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| Name | Class |
|---|---|
| Albert Einstein College of Medicine | OTHER |
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The goal of this research is to investigate the impact of changing opioid analgesic prescribing defaults on the quantity of opioids prescribed for acute non-cancer pain in adult dentistry settings. We will change prescribing defaults for select short-acting opioid analgesics including immediate release oxycodone and hydrocodone as well as codeine and tramadol, including their co-formulations with acetaminophen. In a cluster-randomized trial of three Montefiore Medical Center dentistry sites, we will evaluate the impact of this intervention on patient-level outcomes using 18 months of data (6 months pre-intervention and 12 months post-intervention).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 10-pill default | Experimental | The intervention condition consists of a change to the electronic health record so that new opioid analgesic prescriptions automatically default to 10 pills (i.e., the "quantity dispensed" field is pre-populated). This value is modifiable by providers who can tailor the prescription based on clinical factors. |
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| 5-pill default | Experimental | New opioid analgesic prescriptions will automatically default to 5 pills. |
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| Standard of care | No Intervention | The control condition will be the usual electronic health record interface. The default number of pills varies by medication, most medications currently have either a blank default or a default of 30 pills. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Change in electronic health record default for new opioid analgesic prescriptions | Other |
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| Measure | Description | Time Frame |
|---|---|---|
| Initial prescription number of pills to dispense | From the electronic health record | Through study completion (18 months) |
| Measure | Description | Time Frame |
|---|---|---|
| Initial prescription morphine milligram equivalents to dispense | From the electronic health record | Through study completion (18 months) |
| Opioid analgesic reorder (y/n) | From the electronic health record |
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Clinical Site Inclusion Criteria:
Patient Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Marcus Bachhuber, MD | Montefiore Medical Center | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35792881 | Derived | Bachhuber MA, Nash D, Southern WN, Heo M, Berger M, Schepis M, Sugarman OK, Cunningham CO. Reducing Opioid Analgesic Prescribing in Dentistry Through Prescribing Defaults: A Cluster-Randomized Controlled Trial. Pain Med. 2023 Jan 4;24(1):1-10. doi: 10.1093/pm/pnac106. |
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| ID | Term |
|---|---|
| D059787 | Acute Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Within 30 days after the initial prescription |
| Total opioid analgesic pills to dispense, including re-orders | From the electronic health record | Within 30 days after the initial prescription |
| Total morphine milligram equivalents to dispense, including re-orders | From the electronic health record | Within 30 days after the initial prescription |
| Outpatient visits | From the electronic health record | Within 30 days after the index prescription |
| Emergency department visits | From the electronic health record | Within 30 days after the initial prescription |
| Hospitalizations | From the electronic health record | Within 30 days after the initial prescription |