A research study authored by members of the University of Wisconsin Department of Family Medicine and Community Health examining how different types of support for clinics affected opioid prescribing and overall costs has been published in Annals of Family Medicine. The study, “Budget Impact Analysis of the Balanced Opioid Initiative: A Cluster Randomized Trial Aimed at Deprescribing Opioids for Chronic Pain in Primary Care Settings,” appears in the January/February 2026 issue. Andrew Quanbeck, PhD, Xiang Li, MS, Ella Butzine, and Randy Brown, MD, PhD are the study’s authors, along with Andrew Cohen, PharmD of Emplify Health.
The Annals of Family Medicine: 24 (1)
Thirty-two primary care clinics were split into four groups and studied using four approaches to support for following opioid prescribing guidelines: education and feedback only, education and feedback plus help changing clinic workflows, education and feedback plus coaching for prescribers, and education and feedback plus both help with changing clinic workflows and coaching for prescribers. Changes in average opioid dose, testing and screening practices, and total costs were compared for the study.
The researchers found that while education and feedback had the lowest upfront cost, its association with more expensive urine drug testing made it the costliest approach overall. The lowest overall cost among the four approaches was the combination of education and feedback plus clinic workflow support. The largest reductions in average opioid dose came with education and feedback plus both clinical workflow support and prescriber coaching. The combination of clinic workflow support and prescriber coaching also helped clinics stay more in line with shifting clinical guidelines for opioid prescribing.
Annals of Family Medicine is an open access, peer-reviewed research journal dedicated to advancing knowledge essential to understanding and improving health and primary care and supports a learning community of those who generate and use information about health and generalist health care.
Published: January 2026