Nudging for Better Prescribing Practices

Penn Medicine Research Center, Testing New Approaches to Reducing Opioid Abuse Risk

The Center for Health Incentives and Behavioral Economics (CHIBE) at the Perelman School of Medicine, University of Pennsylvania is currently working on a variety of fronts to address the issue of opioid overdose risk. CHIBE seeks to combine psychology and economics with clinical expertise to illuminate the health related decision making of individuals and to advocate for best practices to encourage healthy behaviors. With respect to prescription opioid misuse, CHIBE has undertaken a 3 year study to assess whether shifting the default options on electronic health records and regular sharing of prescribing patterns can “nudge” clinicians to lower rates of opioid prescribing. Lead researcher Amol Navathe, MD, PhD, associate director of CHIBE, commented, “Physicians know guidelines exist about opioid dosages and durations, but translating evidence-based knowledge into practice can be difficult when in a patient encounter. Our goal isn’t to introduce new standards, but to subtly nudge physicians to fit their prescribing patterns back into the established guidelines, prescribe lower doses of opioids for shorter durations, and opt for alternative treatments when possible.”

Other work underway at CHIBE seeks to improve the evidence base for opioid prescribing by getting a more refined sense of the general baseline need for opioids following specific procedures. The goal is to develop recommendations that result in more informed, data-driven opioid prescribing patterns, according to the authors. Other researchers at CHIBE are working to develop a “decision support tool” that can facilitate conversations between patients and clinicians about nonopioid treatment alternatives for pain. While initially focused on acute pain presentations in the Emergency Department, the objective is to devise a tool that converts easily to additional patient populations.

Read about the CHIBE research activities.

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