Final Research Report
View this project's final research report.
Results of This Project
Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.
The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments.
Peer reviewers commented and the researchers made changes or provided responses. Those comments and responses included the following:
- The reviewers asked the researchers to comment on the low rates of opioid prescribing for non-cancer pain in primary care, noting that the low rates might change initial assumptions that higher prescribing rates are related to lower-quality care. The researchers said that in qualitative interviews with providers participating in the study, the providers felt that they had already adopted safer opioid prescribing practices and felt the intervention was unlikely to be beneficial. The researchers went on to state that they did not believe lower-than-expected prescribing rates changed the mechanism by which the behavioral interventions affected physician prescribing but acknowledged that providers were less likely to be exposed to the interventions because they were prescribing opioids less often and therefore not triggering the intervention.
- The reviewers commented that the study goals emphasized access to pain management without opioids as well as prevention of unsafe opioid prescribing, but there were no direct measures of providing access to or engagement in nonopioid pain management. The researchers explained that they did collect information on nonopioid pain management but ended up deemphasizing this information because nonopioid pain management was the main choice made by providers and therefore not as informative or interesting as prescribing-related quality of care. They added results to the report on nonopioid pain management in two new tables.
- Reviewers asked the researchers to justify their claim that the study sample of participants was diverse and representative of the population and also asked why the researchers included the University of Utah Health Care system when their stakeholders had focused on western Pennsylvania. The researchers agreed that their study sample was not racially or ethnically diverse due to the clientele at the participating clinical sites but considered the sample geographically diverse and geographically representative of the population. They also explained that the University of Utah participated because it was in the health system network involved in this research, Utah offered a more ethnically diverse population, and because Utah had some of the highest rates of opioid prescribing and opioid-related deaths.
- The reviewers requested that the researchers consider the potential impact of selection bias on the results from the qualitative study and for the Pain, Enjoyment, General Activity scale data analyses. The researchers agreed that collection of Pain, Enjoyment, General Activity scale data from only one of the sites introduced potential bias and added this information to their study limitations. They also explained how the qualitative interviews originally started with a random selection of providers, but poor recruitment led them to invite all of the providers to participate in interviews. The researchers described this more fully in the report.
- Has Results