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Table 4 Target Patient Population Treated with ≥90 mg/day of Morphine-equivalent Opioid Dose: Change in Outcomes

From: Increasing system-wide implementation of opioid prescribing guidelines in primary care: findings from a non-randomized stepped-wedge quality improvement project

Characteristics Change in Intervention clinics
(N = 271 at exit)
Change in Comparison clinics
(N = 248 at exit)
Change in Intervention versus Comparison clinics
Change from baseline p value Cohen’s d Change from baseline p value Cohen’s d Difference p value Cohen’s d
Completed treatment agreement (past 12 months), % (SE),
95% CI (LB,UB)
41.1 (9.3)
(23.0, 59.3)
< 0.001 1.9 40.9 (8.2)
(24.9, 56.9)
< 0.001 2.0 0.2 (12.2)
(−23.7, 24.1)
0.783 0.0
Completed urine drug testing (past 12 months), % (SE),
95% CI (LB,UB)
38.8 (4.4)
(30.2, 47.4)
< 0.001 2.3 19.1 (7.0)
(5.4, 32.8)
0.036 1.0 19.8 (10.4)
(−0.7, 40.2)
0.020 0.8
Completed depression screening (past 12 months), % (SE),
95% CI (LB,UB)
54.2 (7.6)
(39.4, 69.0)
< 0.001 2.6 60.6 (9.7)
(41.5, 79.7)
< 0.001 2.6 −6.3 (13.1)
(−32.1, 19.4)
0.528 0.2
Completed opioid misuse risk assessment, % (SE),
95% CI (LB,UB)
7.2 (3.8)
(−0.3, 14.7)
0.060 0.9 10.3 (6.6)
(−2.7, 23.3)
0.074 0.6 −3.1 (8.5)
(−19.7, 13.6)
0.582 0.2
Documented PDMP Check (past 12 months)*, % (SE),
95% CI (LB,UB)
56.5 (6.9)
(43.0, 70.0)
< 0.001 3.8 45.2 (8.0)
(29.6, 60.8)
< 0.001 2.3 11.3 (11.3)
(−10.8, 33.4)
0.263 0.4
Co-prescribed benzodiazepines in at least 1 out of 3 past months, % (SE),
95% CI (LB,UB)
−5.8 (3.5)
(−12.6, 0.9)
0.091 0.5 −6.0 (5.1)
(−16.0, 4.0)
0.039 0.4 0.1 (6.7)
(−13.0, 13.3)
0.486 0.0
Percentage of the adult clinic population, % (SE),
95% CI (LB,UB)
−0.2 (0.1)
(−0.3, 0.0)
0.030 0.4 −0.1 (0.0)
(− 0.1, 0.0)
0.031 0.3 −0.1 (0.1)
(− 0.2, 0.1)
0.224 0.5
MED (past 90 days), mg/day, mean (SE), 95% CI (LB,UB) −26.9 (10.0)
(−46.5, −7.3)
0.007 0.5 −33.8 (16.5)
(−66.2, −1.4)
0.005 0.6 6.9 (21.6)
(−35.3, 49.2)
0.356 0.1
  1. Population of adult patients with chronic non-cancer pain treated with opioid dose ≥ 90 morphine-equivalent mg/day in the 9 intervention and 17 comparison primary care clinics; characteristics at exit (December 2017*) and their patient-weighted change from baseline
  2. CI (LB,UB) Confidence Interval (Lower Bound, Upper Bound), MED Morphine-equivalent Dose, PDMP Prescription Drug Monitoring Program, SE standard error
  3. * Exit data for the PDMP outcome was collected in March 2017; starting in April 2017, the PDMP check documentation rose to approximately 100% across all clinics due to the changes in documentation requirements
  4. p value was determined using the single-sample mean test comparing clinic-level changes in outcomes from baseline to exit
  5. p value was determined using the two-sample means test comparing clinic-level changes in outcomes from baseline to exit for intervention versus comparison clinic groups