A recently published American study has addressed one aspect of the opioid crisis, assessing whether opioid prescribing for patients in emergency departments (EDs) was altered when electronic medical record (EMR) default settings were changed. The study was a quality improvement study involving 4,320 opioid prescriptions from 104 healthcare professionals in two large city EDs. The prescribers were unaware the study study was in progress, but the opioid prescribing behaviours of physicians, nurse practitioners and physician assistants were analysed following random changes from EMR default opioid quantities of 12 and 20 tablets to 0, 5, 10 and 15 tablets. Researchers reported less opioids were prescribed and a smaller proportion of prescriptions surpassing the opioid prescribing guidelines (set by the Centers for Disease Control and Prevention) were issued when default settings were adjusted lower. In addition, each tablet increase in default quantity resulted in an increase of 0.19 tablets prescribed (95% CI, 0.15-0.22). Of 15 pairwise comparisons of default opioid quantities, 8 were associate with a lower number of tablets prescribed in association with lower default settings and one showed a higher number, with no difference observed in six comparisons. The results of this study demonstrate that opioid prescribing behaviour is influenced by default EMR settings, which can be altered to reduce the number of opioids prescribed and ultimately aid in the management and prevention of opioid overuse. Read the original report here.
Contributed by Australian Medication Safety Services Associate – Isabella Singh