Variations in Opioid Prescribing Behavior by Physician Training.

Area of Science:

• Medical research
• Clinical practice
• Public health

Background:

• Opioid abuse is a significant public health crisis in the US.
• Emergency departments (EDs) frequently manage patients with painful conditions requiring analgesia.
• Physician prescribing behaviors for opioids in the ED are known to vary.

Purpose of the Study:

• To investigate if opioid prescribing patterns differ based on provider specialty and training level in the ED.
• To compare opioid prescription amounts among emergency medicine (EM) attending physicians, EM residents, and non-EM residents.

Main Methods:

• Retrospective chart review of ED visits from a single academic hospital (2014-2015).
• Analysis of opioid prescription amounts, measured in morphine milligram equivalents (MME).
• Comparison of MME prescribed by provider specialty and training level (EM attending, EM resident, non-EM resident).

Main Results:

• Of 55,999 ED visits, 7.9% resulted in opioid prescriptions.
• Non-EM residents prescribed significantly higher MME (108) compared to EM attendings (90) and EM residents (75).
• Significant differences in MME prescribing were observed across provider groups (p<0.01).

Conclusions:

• Prescribing patterns for opioid analgesics in the ED vary by provider training and specialty.
• Non-EM residents tend to prescribe larger quantities of opioids for acute pain.
• EM attendings should provide close supervision to ensure appropriate opioid prescribing, avoiding both over- and under-treatment.