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    Area of Science:

    • Pharmacology
    • Public Health
    • Health Informatics

    Background:

    • Opioid misuse and overdose remain critical public health issues in the U.S.
    • A quality improvement study addressed opioid prescribing at the University of Illinois Hospital & Health Sciences System.

    Purpose of the Study:

    • To evaluate the impact of standardizing default electronic health record (EHR) orders for hydrocodone-acetaminophen.
    • To assess changes in opioid prescribing patterns following the intervention.

    Main Methods:

    • The study compared opioid prescription data before and after June 22, 2016.
    • Default orders were modified to one tablet every six hours, with added dispense quantities for 3 and 5 days' supply.
    • Opioid doses were converted to morphine milligram equivalents (MME) for analysis.

    Main Results:

    • Following standardization, monthly prescribed tablets decreased by an average of 19,832.
    • Prescriptions with ≥ 50 MME/day and > 3 days' supply decreased by 5.8% and 2.54%, respectively.
    • Opioid prescriptions with < 50 MME/day and ≤ 3 days' supply significantly increased (OR=1.72, p<0.001 and OR=1.27, p<0.001).

    Conclusions:

    • Standardized EHR default settings significantly influence prescribing behaviors.
    • The intervention successfully reduced opioid tablet quantities and promoted shorter prescription durations.