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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
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BMC Primary Care

ISSN: 2731-4553

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