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Reduction of opioid prescribing through the sharing of individual physician opioid prescribing practices

Published:October 01, 2018DOI:https://doi.org/10.1016/j.ajem.2018.09.052

      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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