De-Implementing Opioid Use and Implementing Optimal Pain Management Following Dental Extractions

取消阿片类药物的使用并在拔牙后实施最佳疼痛管理

基本信息

批准号：
9438338
负责人：
Shannon Gwin Mitchell
金额：
$ 78.51万
依托单位：
HEALTHPARTNERS INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-01 至 2021-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9438338
关键词：
Absence of pain sensation Acetaminophen Acute Adverse effects Analgesics Appointment Automobile Driving Centers for Disease Control and Prevention (U.S.)Clinical Cluster randomized trial Consumption Data Decision Making Dental Dentists Dose Drug Monitoring Drug Prescriptions Education Electronic Health Record Elements Epidemic Evidence based practice Goals Incidence Language Medication Management Methods Morphine Non-Steroidal Anti-Inflammatory Agents Operative Surgical Procedures Opioid Opioid Analgesics Overdose Pain Pain management Patient-Focused Outcomes Patients Pharmaceutical Preparations Postoperative Pain Postoperative Period Provider Public Health Randomized Recommendation Recording of previous events Reporting Risk Safety Symptoms Techniques Testing Time United States Visit arm chronic pain clinical decision-making comparative efficacy disorder prevention electronic data evidence base innovation novel opioid use prescription opioid programs shared decision making support tools systematic review third molar extraction tool trial design

项目摘要

Project Summary The primary objective of this project is to de-implement the use of opioid analgesics for the management of postoperative pain following dental extractions and to implement effective alternative pain management. We propose a cluster-randomized trial design in which dental practitioners will be randomly assigned to 1 of 3 conditions involving different implementation strategies. The first condition, Standard Practice, will serve as a control condition. The second condition will implement a clinical decision support (CDS) tool that will extract patient history and interface with the state prescription drug monitoring program to provide personalized recommendations for analgesic prescribing and offer language for discussing optimal, evidence-based non- opioid pain management with dental extraction patients. The third condition will involve an enhanced version of the CDS (CDS-E) that will also include information regarding optimal, evidence-based, non-opioid pain management delivered directly to the patient both before and following the dental extraction visit. We will examine opioid and non-opioid prescribing data from the electronic health record across study arms as well as other provider- and patient-focused outcomes using mixed methods.

项目概要该项目的主要目标是取消使用阿片类镇痛药来管理拔牙后的术后疼痛并实施有效的替代疼痛管理。提出整群随机试验设计，其中牙科医生将被随机分配到 3 人中的 1 人第一个条件，即标准实践，将作为一个条件。第二个条件将实施临床决策支持（CDS）工具，该工具将提取数据。患者病史并与国家处方药监测程序接口，以提供个性化服务镇痛处方建议，并提供讨论最佳、基于证据的非镇痛药物的语言第三个条件将涉及拔牙患者的阿片类药物疼痛管理。 CDS (CDS-E) 还将包括有关最佳、循证、非阿片类药物疼痛的信息我们将在拔牙就诊之前和之后向患者提供管理。检查各研究组电子健康记录中的阿片类药物和非阿片类药物处方数据以及使用混合方法的其他以提供者和患者为中心的结果。