Table 4 Provider-participant adherence to individual CDC guideline elements, assessed by review of patient-participant electronic health records
From: Toward Safer Opioid Prescribing in HIV care (TOWER): a mixed-methods, cluster-randomized trial
Baseline | Follow-up | p-value | Adjusted p-value | |||
|---|---|---|---|---|---|---|
Control (n = 18) | Intervention (n = 22) | Control (n = 18) | Intervention (n = 19) | |||
1. Non-pharmacologic treatment | 8 (44%) | 12 (54%) | 7 (39%) | 17 (90%) | 0.01 | 0.018 |
2. Non-opioid pharmacologic treatment | 10 (56%) | 18 (82%) | 12 (67%) | 17 (90%) | 0.7 | 0.14 |
3. Treatment goal | 2 (11%) | 2 (9%) | 1 (6%) | 14 (74%) | 0.009 | 0.018 |
4. Discussion of patient opioid responsibilities or written opioid contract | 4 (22%) | 3 (14%) | 4 (22%) | 9 (47%) | 0.01 | 0.018 |
5. Median MME (IQR) | 24.75 (9.375, 101.25) | 60 (45, 175) | 24.75 (9.375, 101.25) | 75 (40, 160) | 0.2 | 0.26 |
6. Had visits with patient at least every 3 months | 13 (72%) | 16 (73%) | 10 (56%) | 14 (74%) | 0.3 | 0.32 |
7. Assessed opioid benefit | 7 (39%) | 7 (32%) | 9 (32%) | 19 (68%) | < 0.0001 | 0.0003 |
8. Assessed opioid harm or risk of harm | 16 (89%) | 20 (91%) | 17 (94%) | 19 (100%) | < 0.0001 | 0.0003 |
9. Reviewed PDMP data | 9 (50%) | 11 (50%) | 12 (67%) | 19 (100%) | < 0.0001 | 0.0003 |
10. Performed urine drug testing | 8 (44%) | 14 (64%) | 9 (50%) | 15 (79%) | 0.3 | 0.32 |
11. Patient not co-prescribed benzodiazepines | 18 (100%) | 19 (86%) | 18 (100%) | 16 (84%) | 0.5 | 0.5 |
12. Follow-up planned within 1–4 weeks, if dose increased | 18 (100%) | 22 (100%) | 18 (100%) | 22 (100%) | N/A | N/A |
13. Documented whether or not a high risk situation was suspected, and if so documented a plan to manage it | 1 (5%) | 5 (23%) | 3 (17%) | 18 (95%) | < 0.0001 | 0.0003 |
14. Low risk patient, or if high risk provided naloxone | 9 (50%) | 5 (23%) | 9 (53%) | 12 (63%) | 0.03 | 0.048 |