Adapting and evaluating a complex adaptable intervention to reduce opioid prescribing in primary care (Opioid SMART) – WP1&2
Opioid prescribing in primary care
We will conduct a randomised feasibility study with a nested qualitative study, with cluster randomisation at the practice-level. We have already shown that it is feasible and acceptable to recruit primary care practices and deliver audit and feedback (A&F) reports on opioid prescribing using routinely collected electronic health record data in the study area (The Campaign to Reduce Opioid Prescribing [CROP]). Therefore, this study will assess the feasibility and acceptability of the feedback facilitation components in addition to A&F, as well as assess the feasibility and acceptability of our updated A&F reports. Eight practices will be identified from Yorkshire and Humber who have previously received an audit and feedback intervention (i.e., CROP) and are not within the West Yorkshire Integrated Care Board (ICB). We will randomly allocate practices (1:1) to receive bimonthly audit and feedback only, or to receive bimonthly audit and feedback with feedback facilitation and bimonthly follow up telephone calls. All practices will receive their intervention for 6 months. A copy of the audit and feedback will be emailed to the practice along with a QR code to access their online depository for feedback reports. For practices allocated the feedback facilitation, the support session will be delivered by the research team and is expected to last between 90 to 120 minutes. The session will take place at a time and place (e.g., in-person or online) convenient for the practice. We will ask a range of practice staff to take part in these sessions, including a minimum of one to two prescribers, lead GP, and practice manager or quality improvement lead. The session will involve educational components, local barrier identification and action planning to improve clinical performance. Quantitative data will include routinely collected data, aggregated at practice-level, from the electronic health record data. Data items will relate to the audits from WP1 for inclusion in feed
WP1 - workshops: 1. Consents to take part in ‘World café’ stakeholder workshops and/or individual testing rounds 2. Prescribes opioid medication in primary care (clinicians), or is involved in quality improvement in primary care, or commissions services, including medicines optimisation, for primary care, or has expertise in delivering A&F and/or FF, or is a member of the Opioid SMART PPIE group WP2 – feasibility trial: 1. Practice within Yorkshire and Humber that has previously received the CROP intervention and is not located within WY-ICB 2. Not currently in receipt of other interventions that aim to reduce prescribing of opioid medication 3. Able to identify a lead clinician or quality improvement lead for the study 4. Willing to take part in a feedback facilitation event WP2 – staff interviews: 1. Healthcare staff with a prescribing or quality improvement role within the practice 2. Employed or role within the practice during the intervention delivery period
WP1 - workshops: 1. Unable to speak or read English 2. Unable to attend workshops or an in-person or online testing round WP2 – feasibility trial: 1. Practice providing enhanced services for drug dependency 2. Practice in lowest ICB decile for opioid prescribing WP2 – staff interviews: 1. Unable to provide written consent 2. Unable to meet in person or online for an interview