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Variation in opioid prescribing patterns between ED providers.

Peter B Smulowitz1, Chris Cary2, Katherine L Boyle3

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Summary
This summary is machine-generated.

Emergency physicians show significant variation in opioid prescribing habits. Understanding these patterns is key to addressing the opioid epidemic and reducing diversion for non-medical use.

Keywords:
Emergency departmentOpioidsVariation

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Area of Science:

  • Emergency Medicine
  • Pharmacology
  • Public Health

Background:

  • Opioid prescription drug abuse is a major public health crisis.
  • Emergency physicians, while prescribing a small fraction of total opioids, contribute to community supply and potential diversion.
  • Knowledge of current prescribing patterns is essential for effective reduction strategies.

Purpose of the Study:

  • To assess the extent of variation in opioid prescribing patterns among physicians at a single institution.
  • To identify physician-level differences in opioid prescription rates per patient.
  • To analyze variations in the number of pills prescribed per opioid prescription.

Main Methods:

  • Single-institution observational study at a community hospital ED.
  • Data collected from November 2014 to July 2015 for 21 full-time providers.
  • Analyzed total prescriptions, patient volume, prescriptions per patient, and pills per prescription.

Main Results:

  • Opioid prescriptions were written for 12.7% of patients seen (127 per 1000 visits).
  • Significant physician-level variation observed, with rates from 33 to 332 per 1000 visits.
  • Substantial variation in pills per prescription (16-40% coefficient of variation) also noted.

Conclusions:

  • There is significant variation in opioid prescribing practices at the individual physician level.
  • This variability exists even after accounting for patient volume.
  • Addressing prescribing variations may be a target for interventions to combat the opioid epidemic.