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Table 2 Data sources

From: Study protocol for evaluating Six Building Blocks for opioid management implementation in primary care practices

Source

Unit of observation

Type

Domains/content

Frequency

Semi-structured staff interviews

QI leads, clinical champions, key staff involved in implementation

Qualitative

Adaptability, complexity, design quality and packaging, execution*

Barriers and facilitators to implementation

Adoption, acceptability, feasibility, appropriateness, sustainability**

Lessons learned

At study startup, midway through, and end

Call notes/emails

Health care organizations

Qualitative

Barriers and facilitators to implementation

Adaptability, acceptability, feasibility**

Ongoing

Practice documents

Health care organizations

Qualitative

Intermediate outcomes and care processes (6BBs):

Opioid prescribing policies and procedures, clinical workflows, dashboards, patient registries, patient agreements, training and education offerings, opioid tracking and monitoring reports, care plan templates, patient educational materials, screening tools related to opioid management, referral processes between primary care and behavioral health and/or pain specialists

Ongoing

Clinical staff survey

Clinical staff: primary care providers, behavioral health providers, nurses, social workers, medical assistants

Quantitative

Penetration**

Engagement in implementation

Prescribing self-efficacy (prescribers only)

Burnout

Adaptive reserve***

At study startup and 12 months later

6BBs Milestones worksheet

Health care organizations

Quantitative

Adoption and fidelity**

At study startup, midway through, and end

Opioid quality improvement measures

Clinics within health care organizations

Quantitative

Effectiveness measures (CDC Guideline):

• Proportion of patients on long-term opioid therapy prescribed ≥ 90 MMEs per day

• Proportion of patients on long-term opioid therapy co-prescribed a benzodiazepine

• Proportion of patients with a new opioid prescription for chronic pain with documentation that a prescription drug monitoring program was checked prior to prescribing

• Proportion of patients with a new opioid prescription for chronic pain with documentation that a urine drug test was performed prior to prescribing

Quarterly for study duration

  1. *The Consolidated Framework for Implementation Research. 2019. Available from https://cfirguide.org/constructs/
  2. **Proctor et al. [19]
  3. ***Jaén et al. [23]