"Low 5": A Five-Step Electronic Medical Record Prescribing Checklist to Lower Opioid Prescribing in Primary Care

Since the start of the 21st Century, the use of opioids for pain management in primary care has increased along with a concomitant rise in opioid associated deaths. The use of opioids is associated with risks of addiction, respiratory depression, sedation, and death. There is no checklist available in electronic medical records to guide safe prescribing of non-opioid pain management options prior to opioids in primary care. Our quality improvement project pilot study aimed to reduce unnecessary opioid prescribing in an urban academic internal medicine clinic by incorporating a checklist of five first-line non-opioid therapy suggestions into electronic medical records. Following its implementation, opioid prescribing dropped by an average of 38.4 percent per month.