NCT03584789

De-Implementing Opioids for Dental Extractions

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

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 5,722 (actual)
• Sponsor: HealthPartners Institute · Academic / Other
• Sex: All
• Age: 16 Years
• Healthy volunteers: Not accepted

Summary

The overarching goal of this project is to de-implement the reliance on opioid analgesics and to implement reliance on non-opioid analgesics to manage postoperative pain following dental extractions. Using a prospective, provider-level, 3-arm cluster randomized trial design, the investigators will compare different strategies to reduce the reliance on opioids and increase the use of alternative pain management approaches utilizing information support tools aimed at both providers and their patients.

Detailed description

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. The investigators 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. The investigators 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.

Conditions

• Tooth Extraction

Interventions

Type	Name	Description
OTHER	Clinical Decision Support	A clinical decision support system designed to assist dentists in providing optimal pain management for patients without resorting to opioids when a non-opioid alternative would suffice. It provides pertinent clinical information to the dentist, including point-of-care access to the Prescription Drug Monitoring Program.
OTHER	Patient education	Patient education regarding pain management before and after dental extraction, including information about the risks and benefits of various strategies.

Timeline

• Start date: 2020-02-17
• Primary completion: 2021-05-14
• Completion: 2021-05-21
• First posted: 2018-07-12
• Last updated: 2022-08-30
• Results posted: 2022-07-19

Locations

1 site across 1 country: United States