Abstract
Background
Drug overdoses are the most common cause of accidental death in the United States,
with the majority being attributed to opioids. High per capita opioid prescribing
is correlated with higher rates of opioid abuse and death. We aimed to determine the
impact of sharing individual prescribing data on the rates of opioid prescriptions
written for patients discharged from the emergency department (ED).
Methods
This was a pre-post intervention at a single community ED. We compared opioid prescriptions
written on patient discharge before and after an intervention consisting of sharing
individual and comparison prescribing data. Clinicians at or over one standard deviation
above the mean were notified via standard template electronic communication.
Results
For each period, we reported the median number of monthly prescriptions written by
each clinician, accounting for the total number of patient discharges. The pre-intervention
median was 12.5 prescriptions per 100 patient discharges (IQR 10–19) compared to 9
(IQR 6–11) in the post-intervention period (p < 0.001). This represents a 28% reduction
in the overall rate of opioid prescriptions written per patient discharged. Using
interrupted time series analysis for monthly rates, this was associated with a reduction
in opioid prescriptions, showing a decrease of almost 9 prescriptions for every 100
discharges over the 6 months of the study (p = 0.032).
Conclusion
Our study demonstrates the sharing of individual opioid prescribing data was associated
with a reduction in opioid prescribing at a single institution.
Keywords
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References
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Article Info
Publication History
Published online: October 01, 2018
Accepted:
September 29,
2018
Received in revised form:
September 28,
2018
Received:
June 18,
2018
Footnotes
☆This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
☆This work has previously been presented in abstract form at the Society for Academic Emergency Medicine in Orlando, Florida, in May 2017.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
