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Table 3 Target Patient Population: 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 = 1255 at exit)

Change in Comparison clinics

(N = 1632 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)

32.0 (6.7)

(18.8, 45.2)

< 0.001

2.1

29.2 (6.7)

(16.1, 42.4)

< 0.001

1.5

2.8 (9.6)

(−16.1, 21.6)

0.816

0.1

Completed urine drug testing (past 12 months), % (SE),

95% CI (LB,UB)

33.4 (7.0)

(19.8, 47.1)

< 0.001

2.6

25.7 (5.3)

(15.3, 36.1)

< 0.001

1.7

7.7 (8.7)

(−9.3, 24.7)

0.277

0.4

Completed depression screening (past 12 months), % (SE),

95% CI (LB,UB)

49.2 (6.1)

(37.2, 61.1)

< 0.001

3.4

55.4 (6.9)

(41.8, 69.0)

< 0.001

3.3

6.2 (9.6)

(−25.1, 12.6)

0.526

0.3

Completed opioid misuse risk assessment, % (SE),

95% CI (LB,UB)

5.4 (3.0)

(−0.5, 11.3)

0.070

0.9

10.1 (5.8)

(−1.4, 21.5)

0.050

0.7

−4.7 (7.4)

(−19.2, 9.9)

0.417

0.3

Documented PDMP* Check (past 12 months), % (SE),

95% CI (LB,UB)

50.7 (6.3)

(38.3, 63.1)

< 0.001

3.8

39.9 (7.8)

(24.6, 55.2)

< 0.001

2.0

10.8 (10.8)

(−10.4, 32.0)

0.301

0.4

Co-prescribed benzodiazepines in at least 1 out of 3 past months, % (SE),

95% CI (LB,UB)

−1.2 (1.6)

(−4.3, 1.9)

0.461

0.3

−5.4 (1.8)

(−9.0, − 1.8)

0.006

0.7

4.3 (2.7)

(−0.9, 9.5)

0.143

0.7

Percentage of the adult clinic population, % (SE),

95% CI (LB,UB)

−0.3 (0.2)

(− 0.6, 0.0)

0.042

0.4

−0.4 (0.1)

(− 0.6, − 0.1)

0.056

0.5

0.0 (0.2)

(− 0.3, 0.4)

0.547

0.1

MED (past 90 days), mg/day, mean (SE),

95% CI (LB,UB)

−11.6 (2.4)

(− 16.4, − 6.9)

< 0.001

0.4

−9.9 (3.0)

(− 15.8, − 4.1)

0.0001

0.6

−1.7 (4.0)

(− 9.6, 6.2)

0.937

0.2

MED ≥ 90 mg/day (past 90 days), % (SE),

95% CI (LB,UB)

−3.5 (1.1)

(− 5.8, − 1.3)

0.002

0.4

− 1.6 (0.7)

(− 3.0, − 0.1)

0.004

0.2

−2.0 (1.3)

(− 4.5, 0.6)

0.270

0.7

  1. Population of adult patients with opioid-treated chronic non-cancer pain 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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