# Nudging Primary Care Providers toward Guideline-Recommended Opioid Prescribing through Easier and More Convenient EHR Information Design

> **NIH NIH R33** · INDIANA UNIVERSITY INDIANAPOLIS · 2021 · $546,825

## Abstract

In line with the National Institute on Drug Abuse mission to advance science on drug use and addiction, the
goal of this research is to encourage appropriate opioid prescribing for chronic pain, using behavioral
economics and electronic health records (EHRs). First, a chronic pain dashboard will be implemented in an
EHR. The dashboard will help primary care providers (PCPs) easily and conveniently review the information
they need to prescribe opioids as recommended by the Centers for Disease Control and Prevention’s (CDC)
2016 Guideline for Prescribing Opioids for Chronic Pain. Second, the pain dashboard will be pilot tested. Last,
a pragmatic trial will be conducted to assess the effect of the pain dashboard on PCPs’ review of guideline-recommended
risk, benefit, and goal information and on guideline-recommended medication ordering
behavior. The hypothesis is that the pain dashboard will nudge PCPs toward (i) more complete assessment of
risk, benefits, and goals and (ii) guideline-concordant medication prescribing behavior. The specific aims are:
Specific Aim 1: Implement and establish feasibility of a chronic pain dashboard in an enterprise EHR in a large
urban safety-net health system.
Aim 1a: Implement a chronic pain dashboard in an enterprise EHR. Building on an ongoing collaboration
with Eskenazi Health system, the chronic pain dashboard will be implemented in the Epic EHR system.
Aim 1b: Pilot test the dashboard’s proposed mechanism of action and verify feasibility of a pragmatic trial. A
series of simulated clinical visits will be conducted with 15-25 PCPs to test the expected effect of the
dashboard on ease and convenience of accessing risk, benefit, and goal information, and on guidelineconcordant
prescribing. Proposed outcome measures, sample size estimates, and recruitment goals will be
validated for a subsequent pragmatic trial.
Specific Aim 2: Across two health systems, implement the chronic pain dashboard in primary care clinics and
evaluate its effect on PCPs’ review of guideline-recommended risk, benefit, and goal information (primary
outcome) and guideline-concordant medication prescribing behavior (secondary outcomes). A two-arm
pragmatic cluster randomized controlled trial with 80 PCPs will be conducted across two health systems.
This innovative project will be the first to implement and test an EHR decision support tool that uses behavioral
economics to increase adoption of chronic pain guideline recommendations. This study will create new
technology that healthcare organizations and clinicians can use to increase safe and effective care for the
millions of Americans who suffer from chronic pain.

## Key facts

- **NIH application ID:** 10232155
- **Project number:** 5R33DA046085-05
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Christopher Albert Harle
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $546,825
- **Award type:** 5
- **Project period:** 2017-09-01 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10232155

## Citation

> US National Institutes of Health, RePORTER application 10232155, Nudging Primary Care Providers toward Guideline-Recommended Opioid Prescribing through Easier and More Convenient EHR Information Design (5R33DA046085-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10232155. Licensed CC0.

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