Trial Outcomes & Findings for Postoperative Nudges to Reduce Opioid Prescribing (NCT NCT05070338)
NCT ID: NCT05070338
Last Updated: 2025-04-08
Results Overview
Prescriptions will be compared to prescribing guidelines via morphine milligram equivalents (MMEs) and coded as within or above guidelines. If no opioid is prescribed at discharge, this will be coded as within guidelines.
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
640 participants
Primary outcome timeframe
12 months
Results posted on
2025-04-08
Participant Flow
Start date: October 19, 2021; Primary Completion Date: October 18, 2022; Study completion date: October 18, 2023. Participants were recruited from hospitals in the Sutter care health system.
Unit of analysis: Specialty-hospital clusters
Participant milestones
| Measure |
Guideline-Based Nudges
Guideline-Based (Injunctive Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amounts recommended by safety guidelines for these procedures.
For patient safety, Sutter Health recommends prescribing within the ranges below for these procedures. Doing so will also meet best-practice safety guidelines for post-operative opioid prescribing.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
|
Peer-Based Nudges
Peer-Based (Social Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amount prescribed by YY% of your peers for these procedures.
YY% of \[specialty\] surgeons at Sutter Health prescribe within the ranges below for these procedures.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
The ranges of 5mg oxycodone tablets displayed will be the same as the ranges stipulated by the prescribing guidelines, but this nudge will not mention guidelines.
|
Control
No intervention
|
|---|---|---|---|
|
Overall Study
STARTED
|
216 19
|
207 19
|
217 19
|
|
Overall Study
COMPLETED
|
216 19
|
207 19
|
217 19
|
|
Overall Study
NOT COMPLETED
|
0 0
|
0 0
|
0 0
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
Race and Ethnicity were not collected from any participant.
Baseline characteristics by cohort
| Measure |
Guideline-Based Nudges
n=216 Participants
Guideline-Based (Injunctive Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amounts recommended by safety guidelines for these procedures.
For patient safety, Sutter Health recommends prescribing within the ranges below for these procedures. Doing so will also meet best-practice safety guidelines for post-operative opioid prescribing.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
|
Peer-Based Nudges
n=207 Participants
Peer-Based (Social Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amount prescribed by YY% of your peers for these procedures.
YY% of \[specialty\] surgeons at Sutter Health prescribe within the ranges below for these procedures.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
The ranges of 5mg oxycodone tablets displayed will be the same as the ranges stipulated by the prescribing guidelines, but this nudge will not mention guidelines.
|
Control
n=217 Participants
No intervention
|
Total
n=640 Participants
Total of all reporting groups
|
|---|---|---|---|---|
|
Age, Continuous
|
49.4 years
STANDARD_DEVIATION 17.6 • n=216 Participants
|
50.1 years
STANDARD_DEVIATION 17.3 • n=207 Participants
|
53.7 years
STANDARD_DEVIATION 17.7 • n=217 Participants
|
51.3 years
STANDARD_DEVIATION 17.6 • n=640 Participants
|
|
Sex: Female, Male
Female
|
83 Participants
n=216 Participants
|
87 Participants
n=207 Participants
|
87 Participants
n=217 Participants
|
257 Participants
n=640 Participants
|
|
Sex: Female, Male
Male
|
133 Participants
n=216 Participants
|
120 Participants
n=207 Participants
|
130 Participants
n=217 Participants
|
383 Participants
n=640 Participants
|
|
Race and Ethnicity Not Collected
|
—
|
—
|
—
|
0 Participants
Race and Ethnicity were not collected from any participant.
|
PRIMARY outcome
Timeframe: 12 monthsPopulation: The units analyzed are the discharges of patients operated on by surgeons enrolled in the study.
Prescriptions will be compared to prescribing guidelines via morphine milligram equivalents (MMEs) and coded as within or above guidelines. If no opioid is prescribed at discharge, this will be coded as within guidelines.
Outcome measures
| Measure |
Peer-Based Nudges
n=10752 Patient discharges
Peer-Based (Social Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amount prescribed by YY% of your peers for these procedures.
YY% of \[specialty\] surgeons at Sutter Health prescribe within the ranges below for these procedures.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
The ranges of 5mg oxycodone tablets displayed will be the same as the ranges stipulated by the prescribing guidelines, but this nudge will not mention guidelines.
|
Guideline-Based Nudges
n=15459 Patient discharges
Guideline-Based (Injunctive Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amounts recommended by safety guidelines for these procedures.
For patient safety, Sutter Health recommends prescribing within the ranges below for these procedures. Doing so will also meet best-practice safety guidelines for post-operative opioid prescribing.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
|
Control
n=12024 Patient discharges
No intervention
|
|---|---|---|---|
|
Proportion of Discharges With Opioid Prescriptions Above Prescribing Guidelines
|
0.275 Proportion of discharges
Interval 0.267 to 0.284
|
0.254 Proportion of discharges
Interval 0.247 to 0.261
|
0.368 Proportion of discharges
Interval 0.359 to 0.376
|
SECONDARY outcome
Timeframe: 12 monthsPopulation: The units analyzed are the discharges of patients operated on by surgeons enrolled in the study.
Continuous measure of the total morphine milligram equivalents prescribed at discharge
Outcome measures
| Measure |
Peer-Based Nudges
n=10752 Patient discharges
Peer-Based (Social Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amount prescribed by YY% of your peers for these procedures.
YY% of \[specialty\] surgeons at Sutter Health prescribe within the ranges below for these procedures.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
The ranges of 5mg oxycodone tablets displayed will be the same as the ranges stipulated by the prescribing guidelines, but this nudge will not mention guidelines.
|
Guideline-Based Nudges
n=15459 Patient discharges
Guideline-Based (Injunctive Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amounts recommended by safety guidelines for these procedures.
For patient safety, Sutter Health recommends prescribing within the ranges below for these procedures. Doing so will also meet best-practice safety guidelines for post-operative opioid prescribing.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
|
Control
n=12024 Patient discharges
No intervention
|
|---|---|---|---|
|
Morphine Milligram Equivalents (MMEs) Prescribed at Discharge
|
58.6 Morphine milligram equivalents (MMEs)
Interval 57.0 to 60.2
|
78.7 Morphine milligram equivalents (MMEs)
Interval 76.8 to 80.6
|
67.6 Morphine milligram equivalents (MMEs)
Interval 65.9 to 69.3
|
SECONDARY outcome
Timeframe: 12 monthsPopulation: Contrary to initial expectations, the days' supply of opioids prescribed at discharge was not captured by the Sutter Health electronic health records system. This outcome measure could therefore not be assessed. The quantity of opioids prescribed at discharge is still captured similarly by the outcome measure Morphine Milligram Equivalents (MMEs) Prescribed at Discharge.
Continuous variable indicating the number of days' supply of opioids prescribed at discharge
Outcome measures
Outcome data not reported
SECONDARY outcome
Timeframe: 12 monthsPopulation: The units analyzed are the discharges of patients operated on by surgeons enrolled in the study.
Derived from a binary variable indicating whether any opioid was prescribed at discharge
Outcome measures
| Measure |
Peer-Based Nudges
n=10752 Patient discharges
Peer-Based (Social Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amount prescribed by YY% of your peers for these procedures.
YY% of \[specialty\] surgeons at Sutter Health prescribe within the ranges below for these procedures.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
The ranges of 5mg oxycodone tablets displayed will be the same as the ranges stipulated by the prescribing guidelines, but this nudge will not mention guidelines.
|
Guideline-Based Nudges
n=15459 Patient discharges
Guideline-Based (Injunctive Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amounts recommended by safety guidelines for these procedures.
For patient safety, Sutter Health recommends prescribing within the ranges below for these procedures. Doing so will also meet best-practice safety guidelines for post-operative opioid prescribing.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
|
Control
n=12024 Patient discharges
No intervention
|
|---|---|---|---|
|
Proportion of Discharges Where Any Opioid Was Prescribed
|
0.476 Proportion of discharges
Interval 0.466 to 0.485
|
0.484 Proportion of discharges
Interval 0.476 to 0.491
|
0.518 Proportion of discharges
Interval 0.509 to 0.527
|
SECONDARY outcome
Timeframe: 3-6 months post-dischargePopulation: The units analyzed are the discharges of patients operated on by surgeons enrolled in the study.
Derived from a binary variable indicating whether the patient has any opioid prescriptions between 3 and 6 months after surgery
Outcome measures
| Measure |
Peer-Based Nudges
n=10752 Patient discharges
Peer-Based (Social Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amount prescribed by YY% of your peers for these procedures.
YY% of \[specialty\] surgeons at Sutter Health prescribe within the ranges below for these procedures.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
The ranges of 5mg oxycodone tablets displayed will be the same as the ranges stipulated by the prescribing guidelines, but this nudge will not mention guidelines.
|
Guideline-Based Nudges
n=15459 Patient discharges
Guideline-Based (Injunctive Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amounts recommended by safety guidelines for these procedures.
For patient safety, Sutter Health recommends prescribing within the ranges below for these procedures. Doing so will also meet best-practice safety guidelines for post-operative opioid prescribing.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
|
Control
n=12024 Patient discharges
No intervention
|
|---|---|---|---|
|
Proportion of Patients on Opioids for Greater Than 3 Months Post-discharge
|
0.099 Proportion of discharges
Interval 0.093 to 0.105
|
0.123 Proportion of discharges
Interval 0.118 to 0.128
|
0.102 Proportion of discharges
Interval 0.097 to 0.108
|
SECONDARY outcome
Timeframe: 0-30 days post-dischargePopulation: The units analyzed are the post-operative discharges of patients operated on by surgeons enrolled in the study. For patients who had multiple procedures in multiple admissions over the study period, each discharge is counted separately.
Number of emergency department visits the post-operative patient has in the 30 days after the initial procedure
Outcome measures
| Measure |
Peer-Based Nudges
n=10752 Patient discharges
Peer-Based (Social Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amount prescribed by YY% of your peers for these procedures.
YY% of \[specialty\] surgeons at Sutter Health prescribe within the ranges below for these procedures.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
The ranges of 5mg oxycodone tablets displayed will be the same as the ranges stipulated by the prescribing guidelines, but this nudge will not mention guidelines.
|
Guideline-Based Nudges
n=15459 Patient discharges
Guideline-Based (Injunctive Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amounts recommended by safety guidelines for these procedures.
For patient safety, Sutter Health recommends prescribing within the ranges below for these procedures. Doing so will also meet best-practice safety guidelines for post-operative opioid prescribing.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
|
Control
n=12024 Patient discharges
No intervention
|
|---|---|---|---|
|
Number of 30-day All-cause Emergency Department Visits
|
0.057 Emergency department visits
Interval 0.052 to 0.062
|
0.062 Emergency department visits
Interval 0.058 to 0.067
|
0.062 Emergency department visits
Interval 0.057 to 0.067
|
SECONDARY outcome
Timeframe: 0-30 days post-dischargePopulation: The units analyzed are the post-operative discharges of patients operated on by surgeons enrolled in the study. For patients who had multiple procedures in multiple admissions over the study period, each discharge is counted separately.
Number of hospital admissions the post-operative patient has in the 30 days after the initial procedure
Outcome measures
| Measure |
Peer-Based Nudges
n=10752 Patient discharges
Peer-Based (Social Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amount prescribed by YY% of your peers for these procedures.
YY% of \[specialty\] surgeons at Sutter Health prescribe within the ranges below for these procedures.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
The ranges of 5mg oxycodone tablets displayed will be the same as the ranges stipulated by the prescribing guidelines, but this nudge will not mention guidelines.
|
Guideline-Based Nudges
n=15459 Patient discharges
Guideline-Based (Injunctive Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amounts recommended by safety guidelines for these procedures.
For patient safety, Sutter Health recommends prescribing within the ranges below for these procedures. Doing so will also meet best-practice safety guidelines for post-operative opioid prescribing.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
|
Control
n=12024 Patient discharges
No intervention
|
|---|---|---|---|
|
Number of 30-day All-cause Hospitalizations
|
0.029 Hospital admissions
Interval 0.025 to 0.032
|
0.023 Hospital admissions
Interval 0.021 to 0.026
|
0.023 Hospital admissions
Interval 0.02 to 0.026
|
SECONDARY outcome
Timeframe: 12 months (months 13-24 of the study)Population: The units analyzed are the discharges of patients operated on by surgeons enrolled in the study.
Prescriptions will be compared to prescribing guidelines via morphine milligram equivalents (MMEs) and coded as within or above guidelines. If no opioid is prescribed at discharge, this will be coded as within guidelines.
Outcome measures
| Measure |
Peer-Based Nudges
n=10752 Patient discharges
Peer-Based (Social Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amount prescribed by YY% of your peers for these procedures.
YY% of \[specialty\] surgeons at Sutter Health prescribe within the ranges below for these procedures.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
The ranges of 5mg oxycodone tablets displayed will be the same as the ranges stipulated by the prescribing guidelines, but this nudge will not mention guidelines.
|
Guideline-Based Nudges
n=15459 Patient discharges
Guideline-Based (Injunctive Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amounts recommended by safety guidelines for these procedures.
For patient safety, Sutter Health recommends prescribing within the ranges below for these procedures. Doing so will also meet best-practice safety guidelines for post-operative opioid prescribing.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
|
Control
n=12024 Patient discharges
No intervention
|
|---|---|---|---|
|
Proportion of Discharge Opioid Prescriptions Above Prescribing Guidelines in the Year After the Intervention Ends
|
0.250 Proportion of discharges
Interval 0.241 to 0.259
|
0.253 Proportion of discharges
Interval 0.246 to 0.261
|
0.363 Proportion of discharges
Interval 0.354 to 0.372
|
Adverse Events
Guideline-Based Nudges
Serious events: 1096 serious events
Other events: 3045 other events
Deaths: 0 deaths
Peer-Based Nudges
Serious events: 755 serious events
Other events: 1752 other events
Deaths: 0 deaths
Control
Serious events: 849 serious events
Other events: 1617 other events
Deaths: 0 deaths
Serious adverse events
| Measure |
Guideline-Based Nudges
n=15459 participants at risk
Guideline-Based (Injunctive Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amounts recommended by safety guidelines for these procedures.
For patient safety, Sutter Health recommends prescribing within the ranges below for these procedures. Doing so will also meet best-practice safety guidelines for post-operative opioid prescribing.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
|
Peer-Based Nudges
n=10752 participants at risk
Peer-Based (Social Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amount prescribed by YY% of your peers for these procedures.
YY% of \[specialty\] surgeons at Sutter Health prescribe within the ranges below for these procedures.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
The ranges of 5mg oxycodone tablets displayed will be the same as the ranges stipulated by the prescribing guidelines, but this nudge will not mention guidelines.
|
Control
n=12024 participants at risk
No intervention
|
|---|---|---|---|
|
General disorders
All-Cause Hospitalizations
|
2.1%
327/15459 • 13 months
A data and safety monitoring board monitored adverse events within 30 days of discharge among patients of enrolled surgeons. The numbers of participants at risk reported reflect the number of patient discharges. Surgeons were not monitored for adverse effects given the minimal risk of receiving emails. Only hospitalizations, ED visits, and opioid refills were monitored. Mortality was not monitored because the intervention did not pose a mortality risk.
|
2.6%
279/10752 • 13 months
A data and safety monitoring board monitored adverse events within 30 days of discharge among patients of enrolled surgeons. The numbers of participants at risk reported reflect the number of patient discharges. Surgeons were not monitored for adverse effects given the minimal risk of receiving emails. Only hospitalizations, ED visits, and opioid refills were monitored. Mortality was not monitored because the intervention did not pose a mortality risk.
|
2.1%
249/12024 • 13 months
A data and safety monitoring board monitored adverse events within 30 days of discharge among patients of enrolled surgeons. The numbers of participants at risk reported reflect the number of patient discharges. Surgeons were not monitored for adverse effects given the minimal risk of receiving emails. Only hospitalizations, ED visits, and opioid refills were monitored. Mortality was not monitored because the intervention did not pose a mortality risk.
|
|
General disorders
All-Cause Emergency Department Visits
|
5.4%
829/15459 • 13 months
A data and safety monitoring board monitored adverse events within 30 days of discharge among patients of enrolled surgeons. The numbers of participants at risk reported reflect the number of patient discharges. Surgeons were not monitored for adverse effects given the minimal risk of receiving emails. Only hospitalizations, ED visits, and opioid refills were monitored. Mortality was not monitored because the intervention did not pose a mortality risk.
|
5.0%
537/10752 • 13 months
A data and safety monitoring board monitored adverse events within 30 days of discharge among patients of enrolled surgeons. The numbers of participants at risk reported reflect the number of patient discharges. Surgeons were not monitored for adverse effects given the minimal risk of receiving emails. Only hospitalizations, ED visits, and opioid refills were monitored. Mortality was not monitored because the intervention did not pose a mortality risk.
|
5.3%
641/12024 • 13 months
A data and safety monitoring board monitored adverse events within 30 days of discharge among patients of enrolled surgeons. The numbers of participants at risk reported reflect the number of patient discharges. Surgeons were not monitored for adverse effects given the minimal risk of receiving emails. Only hospitalizations, ED visits, and opioid refills were monitored. Mortality was not monitored because the intervention did not pose a mortality risk.
|
Other adverse events
| Measure |
Guideline-Based Nudges
n=15459 participants at risk
Guideline-Based (Injunctive Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amounts recommended by safety guidelines for these procedures.
For patient safety, Sutter Health recommends prescribing within the ranges below for these procedures. Doing so will also meet best-practice safety guidelines for post-operative opioid prescribing.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
|
Peer-Based Nudges
n=10752 participants at risk
Peer-Based (Social Norm) Nudges: Surgeons in this arm will receive an email with the following content at the end of each month in which at least two of their patients are discharged with an opioid prescription that exceeds the prescribing guideline for the procedure performed.
Dear Dr. \[Name\],
In \[month\], at least XX of your patients were discharged with opioid prescriptions exceeding the amount prescribed by YY% of your peers for these procedures.
YY% of \[specialty\] surgeons at Sutter Health prescribe within the ranges below for these procedures.
We will continue to send you opioid prescribing safety reports.
Sincerely, \[Signature\]
\[Table displaying recommended ranges of 5mg oxycodone tablets for each procedure\]
The ranges of 5mg oxycodone tablets displayed will be the same as the ranges stipulated by the prescribing guidelines, but this nudge will not mention guidelines.
|
Control
n=12024 participants at risk
No intervention
|
|---|---|---|---|
|
General disorders
Opioid Refills
|
19.7%
3045/15459 • 13 months
A data and safety monitoring board monitored adverse events within 30 days of discharge among patients of enrolled surgeons. The numbers of participants at risk reported reflect the number of patient discharges. Surgeons were not monitored for adverse effects given the minimal risk of receiving emails. Only hospitalizations, ED visits, and opioid refills were monitored. Mortality was not monitored because the intervention did not pose a mortality risk.
|
16.3%
1752/10752 • 13 months
A data and safety monitoring board monitored adverse events within 30 days of discharge among patients of enrolled surgeons. The numbers of participants at risk reported reflect the number of patient discharges. Surgeons were not monitored for adverse effects given the minimal risk of receiving emails. Only hospitalizations, ED visits, and opioid refills were monitored. Mortality was not monitored because the intervention did not pose a mortality risk.
|
13.4%
1617/12024 • 13 months
A data and safety monitoring board monitored adverse events within 30 days of discharge among patients of enrolled surgeons. The numbers of participants at risk reported reflect the number of patient discharges. Surgeons were not monitored for adverse effects given the minimal risk of receiving emails. Only hospitalizations, ED visits, and opioid refills were monitored. Mortality was not monitored because the intervention did not pose a mortality risk.
|
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place