N/A
Completed N=851
Behavioral Insights to Encourage Judicious Prescribing of Opioids
Source: ClinicalTrials.gov NCT02790476 ↗Enrolled (actual)
851
Serious AEs
0.0%
Results posted
Apr 2024
Primary outcomePrimary: Average Change Over Time in Dispensed Narcotics — 347.65; 350.09; 288.36; 318.60 Morphine milligram equivalents — p=<0.05
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.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Average Change Over Time in Dispensed Narcotics |
347.65; 350.09; 288.36; 318.60; 167.83; 182.67 | <0.05 sig |
| PRIMARY Number of Opioid Prescriptions for > 90 Morphine Milligram Equivalent (MME) and ≥ 50 MME |
3.74; 4.59; 3.45; 3.95; 3.00; 3.15 | 0.224 |
| PRIMARY Number of Opioid and Benzodiazepine Co-prescriptions |
12.2; 13.6; 13.4; 16.7 | <0.05 sig |
| SECONDARY Frequency of CURES Use |
— | — |
| SECONDARY Number of "New Start" Prescriptions |
3.72; 3.51; 2.44; 2.26; 2.08; 1.84 | 0.823 |
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
Data sourced from ClinicalTrials.gov (NCT02790476). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.