Clinical Decision Support to Increase Use of Medications for Opioid Use Disorder
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age12-89
SponsorUniversity of Colorado, Denver
About this trial
The objective of this study is to evaluate the impact of clinical decision support (CDS) in the form of an alert to identify patients who may be at risk of opioid use disorder (OUD) and a clinical care pathway helping providers treating patients with opioid use disorder. The pathway provides health care providers with information and suggestions for screening and treatment of opioid use disorder, including treatment with medications. The 2022 Centers for Disease Control and Prevention (CDC) clinical practice guideline for prescribing opioids for pain recommends providers asses for and treat opioid use disorder using approved medications for opioid use disorder (MOUD). This project will implement a passive CDS alert when a provider prescribes an opioid to a patient who may be at risk of opioid use disorder. Providers will also have link access to a clinical care pathway providing support for OUD screening and treatment. Before and after comparisons of buprenorphine (a medication used to treat opioid use disorder) prescribing by providers and outcomes of patients will be examined based on medical records data collected during routine care. The study period will be approximately 18 months.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Primary care encounter AND
Current opioid prescription (not buprenorphine) and Active opioid medications over the last 90 days OR
Documented as on local Pain Registry "Does the patient fit the criteria to be included on the Pain Registry?" OR
Has active problem list diagnosis of long-term (current) use of opiate analgesic OR
Disqualifiers
Active cancer diagnosis in the last 1 year
Hospice care/palliative care order
Sickle cell disease diagnosis
Trial population
Residents and visitors to the state of Colorado who seek healthcare within the University of Colorado Health (UCHealth) primary care system.
Trial design
Design model
Cohort
Time perspective
Prospective
Treatments tested in this trial
Medications for Opioid Use Disorder Pathway Clinical Decision Support (CDS)
Other interventionClinical decision support (CDS) in the form of an electronic health record (EHR)-integrated, provider-facing notification suggesting (a) the patient may be at risk for opioid use disorder and could benefit from screening, (b) patients with opioid use disorder would benefit from treatment with buprenorphine and (c) utilization of a clinical care pathway to help treat patients with opioid use disorder with buprenorphine as suggested by the Center for Disease Control and Prevention (CDC) guidelines.
Treatment groups
200,000 Participants
are divided into 2 treatment groupsGroup A: pre implementation period0 interventions
Group B: CDS Notification1 intervention
Trial outcomes
Primary outcomes
1
Percentage of patients at risk for opioid use disorder receiving medications for opioid use disorder
The number of primary care patients identified to be at risk for opioid use disorder treatment with buprenorphine for treatment divided by the total number of patients meeting opioid use disorder criteria
Time frame
18 monthsSecondary outcomes
1
Clinical decision support (CDS) acceptance rate
The number of times providers accepted the clinical decision support (CDS) tool and utilized the clinical care pathway in treating opioid use disorder.
Time frame
18 months2
Subsequent opioid overdose/poisoning rates
The number of patients who had a diagnosis of opioid overdose or poisoning
Time frame
Six months after an encounter where the opioid use disorder is identified3
Buprenorphine initiation
Number of patients who filled a buprenorphine prescription after being identified at risk.
Time frame
Six months after an encounter where the opioid use disorder is identifiedSponsors and contacts
Click on the lead sponsor to view all of their trials.
University of Colorado, Denver
Lead sponsor
National Institutes of Health (NIH)
Collaborator
National Institute on Drug Abuse (NIDA)
Collaborator
Source ClinicalTrials.gov