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N/A Completed N=47 Randomized Health Services Research

A Clinician-Focused Nudging Intervention to Optimize Post-Surgical Prescribing

Opioid Prescribing · Surgical Procedure, Unspecified
Source: ClinicalTrials.gov NCT05299528 ↗
Enrolled (actual)
47
Serious AEs
2.1%
Results posted
Sep 2024
Primary outcomePrimary: Percentage of Surgeons Approached Who Agree to Participate — 47 Participants

Summary

This is a pilot single site randomized controlled trial to assess the feasibility and acceptability of a nudging intervention providing surgeons with procedure-specific feedback regarding patients' postoperative opioid prescription-to-consumption ratio in individuals 18 years of age and older.

Outcome Measures

OutcomeResultp-value
PRIMARY
Percentage of Surgeons Approached Who Agree to Participate
47
PRIMARY
Percentage of Patients Contacted Who Agree to Participate in Study
135; 27; 31
PRIMARY
Surgeon-reported Acceptability of Intervention
5; 4

Eligibility Criteria

Inclusion Criteria for Patients:

  • Aged greater or equal to 18 years
  • Undergoing specified elective general, gynecologic, orthopedic, and neurological surgeries at VUMC during the specified study periods (days 1-60 for the initial patient group; days 105-164 for the follow-up patient group)
  • General: laparoscopic or open cholecystectomy, laparoscopic or open appendectomy
  • Gynecologic: abdominal hysterectomy, laparoscopic/robotic hysterectomy, vaginal hysterectomy, anterior repair/colporrhaphy, posterior repair/colporrhaphy, tension-free vaginal tape procedure, sacrospinous ligament suspension sacrocolpopexy
  • Orthopedic: total knee arthroplasty, total hip arthroplasty, total shoulder arthroplasty, 1- or 2-level spinal laminectomy (without fusion)
  • Neurological: 1- or 2-level spinal laminectomy (without fusion)
  • Provided postoperative opioid prescription (verified in VUMC electronic medical record (EMR)
  • Able to understand study procedures and participate in the pill count and telephone/electronic interview process in English or Spanish
  • Able to provide informed consent

Exclusion Criteria for Patients:

  • Opioid prescription filled (per VUMC EMR and patient self report) between 3 months and 7 days prior to surgery
  • Primary reason for surgery as assessed by chart review is cancer-related
  • Surgery is a repeat/revision surgery (e.g., revision total knee arthroplasty)
  • Patient has been inpatient for >3 days postoperatively prior to receiving post-discharge prescription
  • Vulnerable populations: current pregnancy, prisoners
  • Prior participation in the study (e.g., a patient included in the initial patient group will not be recontacted for the follow-up patient group)

Inclusion Criteria for Surgeon Participants

-General, gynecologic, orthopedic, or neurological surgeon at VUMC during the study period performing any of the surgeries listed below

  • General: laparoscopic or open cholecystectomy, laparoscopic or open appendectomy
  • Gynecologic: abdominal hysterectomy, laparoscopic/robotic hysterectomy, vaginal hysterectomy, anterior repair/colporrhaphy, posterior repair/colporrhaphy, tension- free vaginal tape procedure, sacrospinous ligament suspension sacrocolpopexy
  • Orthopedic: total knee arthroplasty, total hip arthroplasty, total shoulder arthroplasty, 1- or 2-level spinal laminectomy (without fusion)
  • Neurological: 1- or 2-level spinal laminectomy (without fusion)

Exclusion Criteria for Surgeon Participants - None

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT05299528). 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.

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