Research Areas


Donaghue Foundation

Using Default Options to Decrease Opioid Prescribing Durations

Opioid‐related abuse and overdose represent a growing national epidemic in the United States (US). Physician practice patterns play an important role: opioid prescriptions impact the likelihood that patients will misuse or become dependent on these medications, with longer prescriptions leading to greater sustained use.

The objective of this study is to conduct a pragmatic randomized, controlled trial to evaluate the effect of two scalable behavioral economics approaches to reduce physician opioid prescribing. We will compare the impact of instituting an electronic health record (EHR) default option for the number of pills per opioid prescription and providing monthly social comparison feedback to physicians on opioid prescribing patterns. We will compare EHR default options and social comparison feedback individually and in combination. The trial will compare a one‐year pre‐intervention period to a one‐year intervention period at Sutter Health System in 58 emergency department and urgent care sites throughout the Western US.

The goals of the project are to: 1) evaluate the effectiveness of default options, social comparison feedback, and both approaches combined on reducing the mean number of pills per opioid prescription; 2) evaluate the effectiveness of the interventions on changing the proportion of patients with acute pain that received an opioid prescription; 3) qualitatively explore factors associated with strong or poor performance, mechanisms of effects, and practice experience at the physician and site levels. We will scale successful interventions across the entire network of the participating health care system, as well as broadly disseminate findings and catalyze further trials and implementations nationwide.