Truly food for thought from a recent study published in the prestigious Journal Science. Noting that deaths associated with prescribed opioids often occur among people with common conditions for which prescribing risks outweigh benefits, researchers hypothesised that prescribers may be apt to consider the risks involved to be soemwhat lower than is actually the case on the basis that they may not have personal experiences to guide them, may be less careful with prescribing when they perceived that they were not observed, or may not be as assiduous in the absence of an injunction from authority. 861 clinicians prescribing to 170 persons who subsequently suffered fatal overdoses were studied: the intervention group received notification when a patient they treated died from an opioid overdose, and this was accompanied by a safe prescribing injunction from the county medical examiner. The practices of these clinicians were compared to physicians in a control group did not receive any notification or injunction. Milligram morphine equivalents in prescriptions filled by patients of letter recipients versus controls decreased by 9.7% (95% CI: 6.2 to 13.2%; P < 0.001) over 3 months post-intervention, and fewer opioids were started and fewer high-dose opioid prescriptions were issued by letter recipients. This appears to be a powerful reminder of considering the impact of medicinal opioid use from a human perspective.
Effect of notification of opioid-related deaths upon subsequent opioid prescribing patterns.
Aug 13, 2018