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The Effect of Opioid Prescribing Guidelines on Prescriptions by Emergency Physicians in Ohio.
Ann Emerg Med. 2017 Dec; 70(6):799-808.e1.AE

Abstract

STUDY OBJECTIVE

The objective of our study is to evaluate the association between Ohio's April 2012 emergency physician guidelines aimed at reducing inappropriate opioid prescribing and the number and type of opioid prescriptions dispensed by emergency physicians.

METHODS

We used Ohio's prescription drug monitoring program data from January 1, 2010, to December 31, 2014, and included the 5 most commonly prescribed opioids (hydrocodone, oxycodone, tramadol, codeine, and hydromorphone). The primary outcome was the monthly statewide prescription total of opioids written by emergency physicians in Ohio. We used an interrupted time series analysis to compare pre- and postguideline level and trend in number of opioid prescriptions dispensed by emergency physicians per month, number of prescriptions stratified by 5 commonly prescribed opioids, and number of prescriptions for greater than 3 days' supply of opioids.

RESULTS

Beginning in January 2010, the number of prescriptions dispensed by all emergency physicians in Ohio decreased by 0.3% per month (95% confidence interval [CI] -0.49% to -0.15%). The implementation of the guidelines in April 2012 was associated with a 12% reduction (95% CI -17.7% to -6.3%) in the level of statewide total prescriptions per month and an additional decline of 0.9% (95% CI -1.1% to -0.7%) in trend relative to the preguideline trend. The estimated effect of the guidelines on total monthly prescriptions greater than a 3-day supply was an 11.2% reduction in level (95% CI -18.8% to -3.6%) and an additional 0.9% (95% CI -1.3% to -0.5%) decline in trend per month after the guidelines. Guidelines were also associated with a reduction in prescribing for each of the 5 individual opioids, with various effect.

CONCLUSION

In Ohio, emergency physician opioid prescribing guidelines were associated with a decrease in the quantity of opioid prescriptions written by emergency physicians. Although introduction of the guidelines occurred in parallel with other opioid-related interventions, our findings suggest an additional effect of the guidelines on prescribing behavior. Similar guidelines may have the potential to reduce opioid prescribing in other geographic areas and for other specialties as well.

Authors+Show Affiliations

Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: sweiner@bwh.harvard.edu.Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.Department of Emergency Medicine, Swedish Medical Center, Seattle, WA.State of Ohio Board of Pharmacy, Columbus, OH.Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ.Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28549620

Citation

Weiner, Scott G., et al. "The Effect of Opioid Prescribing Guidelines On Prescriptions By Emergency Physicians in Ohio." Annals of Emergency Medicine, vol. 70, no. 6, 2017, pp. 799-808.e1.
Weiner SG, Baker O, Poon SJ, et al. The Effect of Opioid Prescribing Guidelines on Prescriptions by Emergency Physicians in Ohio. Ann Emerg Med. 2017;70(6):799-808.e1.
Weiner, S. G., Baker, O., Poon, S. J., Rodgers, A. F., Garner, C., Nelson, L. S., & Schuur, J. D. (2017). The Effect of Opioid Prescribing Guidelines on Prescriptions by Emergency Physicians in Ohio. Annals of Emergency Medicine, 70(6), 799-e1. https://doi.org/10.1016/j.annemergmed.2017.03.057
Weiner SG, et al. The Effect of Opioid Prescribing Guidelines On Prescriptions By Emergency Physicians in Ohio. Ann Emerg Med. 2017;70(6):799-808.e1. PubMed PMID: 28549620.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Effect of Opioid Prescribing Guidelines on Prescriptions by Emergency Physicians in Ohio. AU - Weiner,Scott G, AU - Baker,Olesya, AU - Poon,Sabrina J, AU - Rodgers,Ann F, AU - Garner,Chad, AU - Nelson,Lewis S, AU - Schuur,Jeremiah D, Y1 - 2017/05/23/ PY - 2016/12/01/received PY - 2017/03/17/revised PY - 2017/03/22/accepted PY - 2017/5/28/pubmed PY - 2017/11/29/medline PY - 2017/5/28/entrez SP - 799 EP - 808.e1 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 70 IS - 6 N2 - STUDY OBJECTIVE: The objective of our study is to evaluate the association between Ohio's April 2012 emergency physician guidelines aimed at reducing inappropriate opioid prescribing and the number and type of opioid prescriptions dispensed by emergency physicians. METHODS: We used Ohio's prescription drug monitoring program data from January 1, 2010, to December 31, 2014, and included the 5 most commonly prescribed opioids (hydrocodone, oxycodone, tramadol, codeine, and hydromorphone). The primary outcome was the monthly statewide prescription total of opioids written by emergency physicians in Ohio. We used an interrupted time series analysis to compare pre- and postguideline level and trend in number of opioid prescriptions dispensed by emergency physicians per month, number of prescriptions stratified by 5 commonly prescribed opioids, and number of prescriptions for greater than 3 days' supply of opioids. RESULTS: Beginning in January 2010, the number of prescriptions dispensed by all emergency physicians in Ohio decreased by 0.3% per month (95% confidence interval [CI] -0.49% to -0.15%). The implementation of the guidelines in April 2012 was associated with a 12% reduction (95% CI -17.7% to -6.3%) in the level of statewide total prescriptions per month and an additional decline of 0.9% (95% CI -1.1% to -0.7%) in trend relative to the preguideline trend. The estimated effect of the guidelines on total monthly prescriptions greater than a 3-day supply was an 11.2% reduction in level (95% CI -18.8% to -3.6%) and an additional 0.9% (95% CI -1.3% to -0.5%) decline in trend per month after the guidelines. Guidelines were also associated with a reduction in prescribing for each of the 5 individual opioids, with various effect. CONCLUSION: In Ohio, emergency physician opioid prescribing guidelines were associated with a decrease in the quantity of opioid prescriptions written by emergency physicians. Although introduction of the guidelines occurred in parallel with other opioid-related interventions, our findings suggest an additional effect of the guidelines on prescribing behavior. Similar guidelines may have the potential to reduce opioid prescribing in other geographic areas and for other specialties as well. SN - 1097-6760 UR - https://www.unboundmedicine.com/medline/citation/28549620/The_Effect_of_Opioid_Prescribing_Guidelines_on_Prescriptions_by_Emergency_Physicians_in_Ohio_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-0644(17)30353-0 DB - PRIME DP - Unbound Medicine ER -