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Has the rescheduling of hydrocodone changed ED prescribing practices?
Am J Emerg Med. 2016 Dec; 34(12):2388-2391.AJ

Abstract

OBJECTIVE

The objective was to examine the effect of hydrocodone-containing product (HCP) rescheduling on the proportion of prescriptions for HCPs given to patients discharged from the emergency department (ED).

METHODS

Electronic queries of ED records were used to identify patients aged 15 years and older discharged with a pain-related prescription in the 12 months before and after HCP rescheduling. Prescriptions were classified as HCPs; other Schedule II medications (eg, oxycodone products); other Schedule III medications (eg, codeine products); and non-Schedule II/III products (eg, nonsteroidal anti-inflammatory drugs). We compared the proportions of patients receiving each type of prescription before and after rescheduling using χ2 analysis and used logistic regression to explore the relationship between prescription type and time period while controlling for age, sex, race, and ethnicity.

RESULTS

Before rescheduling, 58.1% (95% confidence interval [CI], 57.4-58.7) of patients receiving a pain-related prescription received an HCP; after rescheduling, 13.2% (95% CI, 12.7-13.7) received an HCP (P < .001). Concurrently, other Schedule III prescriptions increased (pre: 11.7% [CI, 11.3-12.2] vs post: 44.9% [CI, 44.2-45.6], P < .001)), as did non-Schedule II/III prescriptions (pre: 51.8% [CI, 51.2-52.5] vs post: 59.3% [CI, 58.6-60.0], P < .001). When controlling for demographic characteristics, patients remained less likely to receive an HCP after rescheduling (adjusted odds ratio [AOR], 0.11; CI, 0.10-0.11) and more likely to receive other Schedule III (AOR, 6.1; CI, 5.8-6.5) and non-Schedule II/III (AOR, 1.4; CI, 1.3-1.4) products.

CONCLUSION

Rescheduling HCPs from Schedule III to Schedule II led to a substantial decrease in HCP prescriptions in our ED and an increase in prescriptions for other Schedule III and non-Schedule II/III products.

Authors+Show Affiliations

Emergency Medicine Residency Program, University of Texas-Austin Dell Medical School/University Medical Center-Brackenridge, Austin, TX.Emergency Medicine Residency Program, University of Texas-Austin Dell Medical School/University Medical Center-Brackenridge, Austin, TX. Electronic address: rlday2@gmail.com.Analytics & Health Economics, Seton Healthcare Family, Austin, TX.Emergency Medicine Residency Program, University of Texas-Austin Dell Medical School/University Medical Center-Brackenridge, Austin, TX; Mount Isa Centre for Rural and Remote Health, James Cook University, Australia, Townsville, QLD Australia.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

27776785

Citation

Oehler, Elizabeth C., et al. "Has the Rescheduling of Hydrocodone Changed ED Prescribing Practices?" The American Journal of Emergency Medicine, vol. 34, no. 12, 2016, pp. 2388-2391.
Oehler EC, Day RL, Robinson DB, et al. Has the rescheduling of hydrocodone changed ED prescribing practices? Am J Emerg Med. 2016;34(12):2388-2391.
Oehler, E. C., Day, R. L., Robinson, D. B., & Brown, L. H. (2016). Has the rescheduling of hydrocodone changed ED prescribing practices? The American Journal of Emergency Medicine, 34(12), 2388-2391. https://doi.org/10.1016/j.ajem.2016.09.002
Oehler EC, et al. Has the Rescheduling of Hydrocodone Changed ED Prescribing Practices. Am J Emerg Med. 2016;34(12):2388-2391. PubMed PMID: 27776785.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Has the rescheduling of hydrocodone changed ED prescribing practices? AU - Oehler,Elizabeth C, AU - Day,Rachel L, AU - Robinson,David B, AU - Brown,Lawrence H, Y1 - 2016/09/03/ PY - 2016/08/05/received PY - 2016/08/31/revised PY - 2016/09/01/accepted PY - 2016/10/26/pubmed PY - 2017/3/18/medline PY - 2016/10/26/entrez SP - 2388 EP - 2391 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 34 IS - 12 N2 - OBJECTIVE: The objective was to examine the effect of hydrocodone-containing product (HCP) rescheduling on the proportion of prescriptions for HCPs given to patients discharged from the emergency department (ED). METHODS: Electronic queries of ED records were used to identify patients aged 15 years and older discharged with a pain-related prescription in the 12 months before and after HCP rescheduling. Prescriptions were classified as HCPs; other Schedule II medications (eg, oxycodone products); other Schedule III medications (eg, codeine products); and non-Schedule II/III products (eg, nonsteroidal anti-inflammatory drugs). We compared the proportions of patients receiving each type of prescription before and after rescheduling using χ2 analysis and used logistic regression to explore the relationship between prescription type and time period while controlling for age, sex, race, and ethnicity. RESULTS: Before rescheduling, 58.1% (95% confidence interval [CI], 57.4-58.7) of patients receiving a pain-related prescription received an HCP; after rescheduling, 13.2% (95% CI, 12.7-13.7) received an HCP (P < .001). Concurrently, other Schedule III prescriptions increased (pre: 11.7% [CI, 11.3-12.2] vs post: 44.9% [CI, 44.2-45.6], P < .001)), as did non-Schedule II/III prescriptions (pre: 51.8% [CI, 51.2-52.5] vs post: 59.3% [CI, 58.6-60.0], P < .001). When controlling for demographic characteristics, patients remained less likely to receive an HCP after rescheduling (adjusted odds ratio [AOR], 0.11; CI, 0.10-0.11) and more likely to receive other Schedule III (AOR, 6.1; CI, 5.8-6.5) and non-Schedule II/III (AOR, 1.4; CI, 1.3-1.4) products. CONCLUSION: Rescheduling HCPs from Schedule III to Schedule II led to a substantial decrease in HCP prescriptions in our ED and an increase in prescriptions for other Schedule III and non-Schedule II/III products. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/27776785/Has_the_rescheduling_of_hydrocodone_changed_ED_prescribing_practices L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(16)30577-0 DB - PRIME DP - Unbound Medicine ER -