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De-implementing opioid prescribing in a dental group practice: Lessons learned.
Donald Brad Rindal1, Jan Gryczynski2, Stephen E Asche1
1HealthPartners Institute, Bloomington, Minnesota, USA.
Community Dentistry and Oral Epidemiology
|February 8, 2023
Summary
Dental providers found training on opioid risks and personalized prescribing data beneficial for reducing opioid prescriptions. Clinical decision support tools showed limited adoption, highlighting challenges in de-implementation efforts.
Area of Science:
- Oral Health Research
- Public Health
- Health Services Research
Background:
- Drug overdose deaths, particularly from opioids, have significantly increased in the US.
- Unnecessary opioid prescribing is a key driver of the opioid epidemic.
- Dental providers play a role in opioid prescribing for post-extraction pain.
Purpose of the Study:
- To share lessons learned from a randomized trial de-implementing opioid prescribing for post-extraction pain.
- To evaluate the effectiveness of clinical decision support (CDS) with and without patient education.
- To inform future dissemination and implementation of oral health research.
Main Methods:
- Qualitative interviews with 20 dental providers post-implementation.
- Tracking of policy, social, and environmental factors.
- A randomized trial involving clinical decision support (CDS) with and without patient education.
Main Results:
- Dental providers valued training on the personal impact of opioid use and pain.
- Dashboards showing comparative prescribing patterns were found useful.
- Clinical decision support (CDS) portal usage varied, with most dentists using it 10%-49% of the time for extractions.
Conclusions:
- Training on negative opioid impacts and personalized feedback are beneficial for reducing prescribing.
- Clinical decision support (CDS) showed modest utilization in this trial.
- External factors like policy and the COVID-19 pandemic influenced trial implementation, necessitating adaptive strategies for opioid de-implementation.
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