Our REDONNA team in British Columbia used a personalized "audit and feedback letter", named Portrait, to see if we could reduce the number of first-time opioid prescriptions for pain. The study was a randomized trial involving all eligible family doctors in BC (~4300!!). It had two groups: EARLY and DELAYED. We compared outcomes for a 6-month window before vs. after each mailed intervention, using differences in percent differences (DPD) with 95% confidence intervals (CI) and odds ratios (OR) from logistic regressions adjusted for clustering of patients by FP.  The main goal was to see if there was a change in the number of new opioid prescriptions before and after using Portrait.  During our trial preparation we found that prescribing rates were already LOW.

The trial found no significant changes in the rates of first-time opioid prescriptions in either group.

From the adjacent webinars and focus groups, we learned a lot about how our intended Portrait messages re: "opioid-sparing" prescriptions were misinterpreted.

Future audit and feedback studies could benefit from qualitative methods used to develop and test efficacy of educational messages.

Link to the full article is here.

I am very grateful to all the people who helped with this study, especially the people with lived experience, the community members and my INCREDIBLE research staff @JanKlimas
@ShawnaNarayan and everyone else!