Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): A Cluster Randomized Multiple Crossover Trial
Primary result · Total postdischarge opioid prescription (oral MME)Result — go to the resultRatio of geometric means 0.95 95% CI 0.80–1.13Authors' conclusion
A decision-support tool incorporated into electronic medical records did not reduce discharge opioid prescribing for postoperative patients in the context of vigorous opioid education and awareness efforts.
Study context
- Population
- Surgical inpatient discharges in four Colorado hospitals, July 2020 to June 2021
- Participants
- 21,689 surgical inpatient discharges
- Comparison
- Alerts active vs Alerts inactive
- Alerts activen = 11,003
- Alerts inactiven = 10,686reference
- Primary endpoint
- Oral MME prescribed at discharge
Methodological detailscluster randomized, multiple crossover, 4-week washout periods, 4 hospitals, State-wide opioid education and awareness campaign in place during the trial
- Cluster randomized
- Multiple crossover
- 4-week washout periods
- 4 hospitals
- State-wide opioid education and awareness campaign in place during the trial
Primary result
As reported in the abstract
Total postdischarge opioid prescription (oral MME)
Ratio of geometric means
0.95
95% CI 0.80–1.13
P = 0.586
By group
Alerts active
75
median · quartile 1, quartile 3 0–225 · oral morphine milligram equivalents
Alerts inactive
100
median · quartile 1, quartile 3 0–225 · morphine milligram equivalents
Alerts active vs Alerts inactive
ratio of geometric means 0.95 (95% CI 0.80–1.13); P = 0.586
Secondary outcomes
- Alert display rate during active periods — Alerts active
- 28%
Combination opioid and nonopioid prescriptions; additional opioid prescriptions until day 28 after discharge
- No relationship between the alert and these outcomes
Original publication
Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): A Cluster Randomized Multiple Crossover Trial. Anesthesiology. Published 8 May 2023. doi:10.
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