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Reduction in Hospital System Opioid Prescribing for Acute Pain Through Default Prescription Preference Settings:
Benjamin Heritier Slovis1,2, Jeffrey M Riggio1,3, Melanie Girondo4
1Office of Clinical Informatics, Thomas Jefferson University, Philadelphia, PA, United States.
Modifying electronic health record (EHR) opioid presets significantly reduced prescription quantities and durations. This intervention in opioid prescribing patterns can help mitigate the ongoing opioid epidemic and reduce overdose risks.
Area of Science:
- Health Informatics
- Public Health
- Pharmacology
Background:
- The United States faces a critical opioid epidemic.
- Electronic health record (EHR) decision support, specifically opioid prescription presets, offers a potential strategy to curb opioid dependence.
Purpose of the Study:
- To evaluate if modifying EHR opioid prescribing presets can alter prescribing patterns across a hospital system.
- To assess the impact of EHR preset adjustments on opioid prescription characteristics.
Main Methods:
- A quasi-experimental, retrospective pre-post analysis was conducted over 24 months.
- EHR opioid presets were modified to align with CDC guidelines, including mandatory duration, a 3-day preset, and a default quantity of 10 tablets.
- Prescription quantity, duration, and proportion exceeding 90 morphine milligram equivalents/day were compared pre- and post-intervention.
Main Results:
- A significant reduction in median tablet quantity dispensed (54 to 42) and treatment duration (10.5 to 7.5 days) was observed.
- The proportion of prescriptions exceeding 90 MME/day decreased from 27.46% to 22.86%.
- These changes were statistically significant (P<.001).
Conclusions:
- Modifications to EHR opioid prescribing presets can effectively improve prescribing practices.
- Reducing opioid prescription duration and quantity is a viable strategy to decrease the risk of opioid dependence and overdose.
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