Opioid-related abuse and overdose represent a growing national epidemic in the United States. Clinician practice patterns play an important role: opioid prescriptions impact the likelihood that patients will misuse or become dependent on these medications, with longer prescriptions leading to greater sustained use. In this study, we will evaluate a Sutter Health System initiative using electronic health record default options and monthly social comparison feedback to clinicians to change opioid prescribing patterns. In partnership with Sutter Health System, this will be conducted as a randomized, controlled trial to evaluate its effect.

We will also conduct a process evaluation to understand factors associated with better or worse performance at the clinician level. In research study analysis, patients will be included in the primary sample if they are age 18 years or older, presenting to a Penn Medicine Emergency department during the study period, and are discharged to home from the visit.