Clinical Decision Support for Opioid Use Disorders in Medical Settings (COMPUTE 2.0)

Summary

Through CTN-0076-Ot (Clinical Decision Support for Opioid Use Disorders in Medical Settings: Pilot Usability Testing in an EMR (COMPUTE)), our team has iteratively developed and piloted a web-based and electronic health record (EHR)-integrated Opioid Use Disorder (OUD) Clinical Decision Support (CDS) system to offer expert guidance to primary care providers (PCPs) on the diagnosis and management of OUD. The OUD-CDS has been implemented within the EPIC EHR of one large care system and was piloted with 55 providers to ensure content validity and provider satisfaction. The team will now implement this OUD-CDS in a large multi-site clinic-randomized controlled trial to evaluate its impact on practice process measures and patient outcomes. The investigators also aim to prepare for scalability (i.e., integration into usual primary care practice after the study is complete) and dissemination by evaluating facilitators and barriers to implementation, determining the costs of implementation and maintenance, and assessing the short-term cost impacts of the OUD-CDS.

The study will include three large diverse care systems and randomize a minimum of 30 clinics to receive the OUD-CDS intervention or usual care (UC). In intervention clinics, the OUD-CDS will identify patients who are at high risk for OUD or diagnosed with OUD; use data stored in the EHR for each eligible patient to assemble treatment recommendations tailored to each patient's current needs; display these recommendations to PCPs via the OUD-CDS user interface; and store analytic data from all targeted visits. In UC clinics, the OUD-CDS will run invisibly in the background to identify high-risk or OUD patients, assemble treatment recommendations tailored to each eligible patient's needs, and store analytic data from all targeted visits.

Conditions

• Opioid-use Disorder

Interventions

OTHER

Opioid Wizard

The Opioid Wizard is an OUD clinical decision support tool for primary care providers to help assess, diagnose, and treat OUD in primary care (where appropriate).

Sponsors & Collaborators

• National Institute on Drug Abuse (NIDA)

  collaborator NIH

• The Emmes Company, LLC

  collaborator INDUSTRY

• Hennepin Healthcare Research Institute

  collaborator OTHER

• Geisinger Clinic

  collaborator OTHER

• Essentia Health

  collaborator OTHER

• HealthPartners Institute

  lead OTHER

Principal Investigators

• Gavin Bart, MD PhD FACP DFASAM · Hennepin Healthcare

• Rebecca Rossom, MD, MSCR · HealthPartners Institute

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

75 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-11-12

Primary Completion

2023-12-31

Completion

2023-12-31

Countries

• United States

Study Locations