Audit of opioid prescribing: the effect of hospital guidelines

The effects of prescribing guidelines for analgesia were assessed by auditing prescriptions for opioids before and after the introduction of hospital prescribing guidelines. Opioid prescriptions were collected by the pharmacy department over a 2-week period in November 1994 and repeated in November 1995. Following the initial audit, analgesic prescribing guidelines were introduced. A statistically significant increase was achieved in the number of prescriptions that were correct for both dose and frequency according to both the British National Formulary recommendations (40-61%; p < 0.001) and our Acute Pain Service guidelines (16-26%; p < 0.05). There was a statistically significant decrease in the number of prescriptions that were inadequate for both dose and frequency according to both the British National Formulary recommendations (18-3%; p < 0.001) and our Acute Pain Service guidelines (36-17%; p = 0.001). The use of accessible prescribing guidelines promotes demonstrable improvements in opioid prescribing.