E-mail Nudges for Safer Opioid Prescribing

Not currently recruiting at 2 trial locations

Overseen By Adam Sacarny, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Columbia University

Disqualifiers: No e-mail address

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether different types of e-mails can help doctors and physician assistants in Minnesota use the state's prescription monitoring program (PMP/PDMP) more effectively. The goal is to determine if these e-mails can lead to safer opioid prescribing, as opioids are pain-relief medications that can be addictive. Two types of e-mails are being tested: the PDMP Clinical Benefit E-mail, which emphasizes the clinical benefits of using the monitoring program, and the PDMP Legal Mandate E-mail, which highlights the legal requirements. The trial seeks Minnesota doctors and physician assistants who prescribe controlled substances but do not regularly use the state's monitoring system. As an unphased trial, this study offers a unique opportunity to contribute to safer opioid prescribing practices.

Will I have to stop taking my current medications?

The trial does not specify whether participants must stop taking their current medications.

What prior data suggests that these e-mail nudges are safe for opioid prescribing?

Research shows that the two types of email reminders in this study, which encourage the use of the Prescription Drug Monitoring Program (PDMP), are generally well-received. These emails aim to help doctors prescribe opioids more safely by providing information on better practices.

For the PDMP Clinical Benefit Email, studies have found that using PDMPs can result in fewer hospital visits related to opioids and lower doses of opioids, suggesting improved safety for patients. However, some mixed results indicate possible unintended effects on how doctors prescribe medications.

Regarding the PDMP Legal Mandate Email, research indicates that PDMP requirements can lead to better patient outcomes by promoting safer prescribing. Still, concerns exist about potential issues, such as doctors prescribing too little for pain.

Overall, while these email reminders are not medications, they are based on existing programs designed to enhance patient safety. No direct negative effects are linked to the emails themselves, making them a low-risk option for those interested in this trial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the trial exploring e-mail nudges for safer opioid prescribing because it aims to influence prescribing behavior in a simple yet impactful way. Unlike traditional methods that rely heavily on regulations and in-person interventions, this approach uses targeted e-mails to remind and educate prescribers. The two types of e-mails being tested—PDMP Clinical Benefit Messaging and PDMP Legal Mandate Messaging—offer a fresh, tech-driven method to potentially enhance patient safety by promoting awareness and adherence to safe prescribing guidelines. This trial seeks to find out if digital reminders can effectively reduce inappropriate opioid prescriptions, offering a low-cost, scalable solution to the opioid crisis.

What evidence suggests that this trial's treatments could be effective for safer opioid prescribing?

Research shows that Prescription Drug Monitoring Programs (PDMPs) can help reduce opioid misuse. Studies have found that PDMPs correlate with fewer opioid prescriptions and fewer hospital visits related to opioids. For example, one study found that requiring electronic prescriptions led to a 22% drop in opioid overdoses. Additionally, more thorough PDMP use resulted in a 4.3% decrease in opioid prescribing. This trial will test two different email nudges to encourage PDMP use: the PDMP Clinical Benefit Email and the PDMP Legal Mandate Email. These emails aim to help doctors prescribe opioids more safely by highlighting the legal and health benefits of monitoring. ^{1 2 3 4 5}

Who Is on the Research Team?

Adam Sacarny, PhD

Principal Investigator

Columbia University

Mireille Jacobson, PhD

Principal Investigator

University of Southern California

Tatyana Avilova, PhD

Principal Investigator

Bowdoin College

Are You a Good Fit for This Trial?

This clinical trial is for healthcare providers in Minnesota who prescribe medications. The goal is to see if certain types of emails can influence their use of the prescription monitoring program and change how they prescribe controlled substances.

Inclusion Criteria

Minnesota physician or physician assistant

Controlled substance prescriber not following state requirements to maintain an active PDMP account, or opioid prescriber not searching the PDMP or infrequently searching the PDMP

Exclusion Criteria

No e-mail address available

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

E-mails are sent to encourage engagement with the Minnesota prescription monitoring program (PMP/PDMP)

2 months

Follow-up

Participants are monitored for changes in PDMP engagement and prescribing behaviors

2 months

What Are the Treatments Tested in This Trial?

Interventions

• PDMP Clinical Benefit E-mail
• PDMP Legal Mandate E-mail

Trial Overview The study tests two kinds of e-mails: one highlighting the legal requirements to use the PMP/PDMP, and another emphasizing its clinical benefits. Researchers will track if these emails affect usage of the PMP/PDMP and prescribing habits.

How Is the Trial Designed?

Group I: Legal Mandate Messaging Experimental Treatment 1 Intervention

Group II: Clinical Benefit Messaging Experimental Treatment 1 Intervention

Group III: Control Active Control 1 Intervention

Who Is Running the Clinical Trial?

Columbia University

Lead Sponsor

Trials

1,529

Recruited

2,832,000+

University of Southern California

Collaborator

Trials

956

Recruited

1,609,000+

Bowdoin College

Collaborator

Trials

5

Recruited

8,300+

Abdul Latif Jameel Poverty Action Lab

Collaborator

Trials

31

Recruited

273,000+

Minnesota Management and Budget

Collaborator

Trials

1

Recruited

7,900+

Minnesota Board of Pharmacy

Collaborator

Trials

2

Recruited

19,900+

Minnesota Board of Pharmacy

Collaborator

Trials

2

Recruited

19,900+

Citations

1. cdc.gov cdc.gov/overdose-prevention/hcp/clinical-guidance/prescription-drug-monitoring-programs.html

Prescription Drug Monitoring Programs (PDMPs) Clinicians should check PDMP data for prescription opioids and other controlled medications patients have received from other clinicians to ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8831644/

The Impact of a PDMP-EHR Data Integration combined ... We identified changes in opioid prescribing by linking prescription data available in the state PMDP database to individual clinicians.

3. sciencedirect.com sciencedirect.com/science/article/pii/S2773065425001488

Examining Statewide Opioid Prescribing Limits and ... Of the 9,423 patients with a second opioid prescription, 58.4% received a seven-day supply or less and 13.1% had a documented PDMP review.

4. withpower.com withpower.com/trial/phase-drug-misuse-6-2024-a7fd2

E-mail Nudges for Safer Opioid Prescribing These programs have been associated with fewer opioid-related hospital visits and reduced opioid dosages, indicating a positive impact on safety. Show more.

5. academic.oup.com academic.oup.com/healthaffairsscholar/article/1/6/qxad067/7456161

Prescription drug monitoring program use by opioid prescribers Using 2023 PDMP data, we found that 4 in 10 opioid prescribers did not search and 2 in 10 did not hold an account. PDMP use was strongly associated with ...