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Opioid Wizard tool increases primary care clinician confidence in screening, diagnosing, and referring patients for OUDDigital Tool Improves Clinician Confidence in Managing Opioid Use Disorder

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Key Takeaway
Note that Opioid Wizard improves clinician confidence in screening and diagnosis but does not increase confidence in buprenorphine treatment.

This secondary analysis of a randomized controlled trial evaluates the impact of Opioid Wizard, an electronic health record-integrated clinical decision support tool, on primary care clinicians (PCCs) managing opioid use disorder (OUD). The study assessed clinician confidence and perceptions regarding the tool's utility in a clinic-based setting.

Key findings indicate that clinics using the Opioid Wizard saw significant increases in clinician confidence for screening (RR 1.32; 95% CI 1.07, 1.62), diagnosing (RR 1.24; 95% CI 1.02, 1.50), and referring patients for OUD care (RR 1.17; 95% CI 1.02, 1.34). In contrast, there was no reported increase in confidence regarding treating OUD with buprenorphine in either the intervention or usual care settings. Regarding usability, 80% of users agreed the tool made tasks easier, and 70% felt time spent on it was well spent.

Despite these gains in confidence, the study noted limitations regarding clinician enthusiasm; only 44% of users were likely to recommend the tool to colleagues. These findings suggest that while integrated decision support tools can improve provider confidence in specific OUD management tasks, they may not automatically translate into high levels of user engagement or broad recommendation rates.

How this fits prior evidence

This finding addresses a gap in clinical workflow by evaluating an electronic health record-integrated tool for managing opioid use disorder. While previous coverage has established buprenorphine induction protocols and highlighted the differences between methadone and buprenorphine in pregnant women, this study specifically focuses on the clinician's confidence and tools used in primary care settings to manage OUD.

Researchers analyzed a trial involving 361 primary care clinicians across 92 clinics. The study looked at how an electronic health record tool, called Opioid Wizard, affected how doctors felt about managing opioid use disorder (OUD) compared to standard care.

Clinicians using the tool reported significantly higher confidence in screening patients, diagnosing them with OUD, and referring them for care. However, the tool did not increase clinician confidence specifically regarding the treatment of patients with buprenorphine. While 80% of users felt the tool made their tasks easier and 70% felt it was a good use of their time, only 44% of those users were likely to recommend it to their colleagues.

Because this is a secondary analysis of an original trial, the results are useful but should be viewed as one piece of evidence. The study shows that while the digital tool helps doctors feel more capable in certain areas of opioid management, it did not change their confidence regarding specific medications or lead to high levels of enthusiasm for the tool overall.

What this means for you:
A digital support tool increased clinician confidence in screening and diagnosing opioid use disorder.

Common questions

How did the tool affect doctor confidence?

Clinicians using the Opioid Wizard tool showed a significant increase in confidence regarding screening for, diagnosing, and referring patients for opioid use disorder care. However, the study found no increase in confidence specifically regarding treating patients with buprenorphine.

Was the tool easy for doctors to use?

The results showed that 80% of the clinicians who used the Opioid Wizard tool agreed that it made their tasks easier. Additionally, 70% of those users felt that using the tool was a good use of their time.

Would doctors recommend this tool to others?

While the tool increased confidence in several areas, only 44% of the clinicians who used it reported they would be likely to recommend the tool to their colleagues. This suggests mixed feelings about its overall adoption.

Study Details

Study typeRct
EvidenceLevel 2
Follow-up9.0 mo
PublishedJul 2026
View Original Abstract ↓
BACKGROUND: Opioid use disorder (OUD) remains a significant public health issue. Yet, few primary care clinicians (PCCs) screen for, diagnose, or treat OUD. Clinical decision support tools (CDS) integrated into the electronic health record improve process and outcome measures across a variety of conditions. We evaluated PCC perspectives on an OUD CDS tool (Opioid Wizard) deployed through a clinic-randomized trial. METHODS: This is a secondary analysis of CTN-0095, a trial evaluating the effectiveness of Opioid Wizard on OUD process and outcome measures. In short, 92 primary care clinics across three health systems were randomized to Opioid Wizard or usual care. PCCs completed online surveys pre- and 9-month post-Opioid Wizard's go-live date. Survey items measured PCC self-reports on their confidence and ability to manage OUD, and for PCCs in Opioid Wizard clinics, perceptions about the tool. Generalized linear mixed models with Poisson distribution estimated change in survey response from baseline to follow-up within each treatment group (risk ratios) and in intervention relative to control clinics (ratio of risk ratios). RESULTS: 361 PCCs (n = 180 Opioid Wizard, n = 181 usual care, 63% female) answered at least one survey. Confidence in screening (RR 1.32, 95% CI 1.07, 1.62), diagnosing (RR 1.24, 95% CI 1.02, 1.50), and referring (RR 1.17, 95% CI 1.02, 1.34) patients for OUD care significantly increased in Opioid Wizard clinics only. Confidence in treating OUD with buprenorphine did not increase in either setting. Of 55 PCCs who used Opioid Wizard at least once, 80% agreed Opioid Wizard made tasks easier and 70% agreed using Opioid Wizard was time "well spent", but only 44% were likely to recommend it to colleagues. CONCLUSION: Opioid Wizard increased PCC confidence across a variety of OUD care measures yet enthusiasm for and use of the tool was limited. Efforts to increase Opioid Wizard use may improve OUD care measures.
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