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Discrepancies in Written Versus Calculated Durations in Opioid Prescriptions: Pre-Post Study
Benjamin H Slovis1,2, John Kairys1,3, Bracken Babula1,4
1Office of the Chief Medical Information Officer, Thomas Jefferson University, Philadelphia, PA, United States.
JMIR Medical Informatics
|April 2, 2020
Summary
Discrepancies in opioid prescription durations were common, with 16.96% exceeding the intended treatment period. Requiring duration documentation in electronic health records reduced this issue, highlighting the need for improved health IT tools to prevent opioid dependence.
Area of Science:
- Public Health
- Health Informatics
- Pharmacology
Background:
- The United States faces a significant opioid epidemic, with long-term opioid use increasing dependence risk.
- The US Centers for Disease Control and Prevention (CDC) recommends aligning opioid prescription quantities with treatment duration.
- Ensuring accurate prescription durations is crucial for mitigating opioid-related risks.
Purpose of the Study:
- To evaluate opioid prescription quantities against intended treatment durations at an institutional level.
- To assess the impact of electronic health record (EHR) system enhancements on prescription duration accuracy.
Main Methods:
- A retrospective analysis of 72,314 opioid prescriptions over 22 months was conducted.
- Prescription duration was compared between documented and calculated values (based on quantity and dosage).
- The effect of making prescription duration a mandatory field in the EHR was examined.
Main Results:
- 16.96% of opioid prescriptions reviewed had a calculated duration exceeding the documented duration.
- Implementing a mandatory duration field in the EHR significantly reduced discrepancies from 17.95% to 16.21% (P<.001).
- Despite improvements, the mandatory field did not entirely eliminate prescription duration discrepancies.
Conclusions:
- Health information technology (HIT) systems should be enhanced to accurately reflect prescription durations by default.
- HIT vendors should consider modifying dispensed doses/quantities based on provider-entered durations.
- These technological improvements could help reduce prolonged opioid use and the potential for long-term dependence.
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