A Randomized Trial of Behavioral Economic Approaches to Reduce Unnecessary Opioid Prescribing

A Randomized Trial of Behavioral Economic Approaches to Reduce Unnecessary Opioid Prescribing

In this study, the investigators will evaluate the effect of a health system initiative aiming to change clinician opioid prescribing behaviors using two behavioral economic interventions - individual audit feedback and peer comparison feedback of clinicians.

Opioid-related abuse and overdose represent a growing national epidemic in the United States. Clinician practice patterns play an important role: opioid prescriptions impact the likelihood that patients will misuse or become dependent on these medications, with longer prescriptions leading to greater sustained use. In this study, we will evaluate a Sutter Health System quality improvement initiative using monthly individual audit feedback and/or monthly peer comparison feedback to clinicians to change opioid prescribing patterns. In partnership with Sutter Health System, this will be conducted using randomization to evaluate its effect. We will also conduct a process evaluation to understand factors associated with better or worse performance at the clinician level.

Inclusion Criteria:

• Clinicians

  1. Practiced primarily at participating emergency department or urgent care center

• Patients

  1. Presented to a participating emergency department or urgent care center during the study period
  2. Discharged to home from the visit

Exclusion Criteria:

• Clinicians

  1. Saw less than 100 patients in the prior year
  2. Practiced primarily at another site that is not in the main trial
  3. Did not practice at Sutter Health in the prior 90 days

• Patients

  1. Currently pregnant