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Effect of an emergency department opioid prescription policy on prescribing patterns.
Am J Emerg Med. 2017 Sep; 35(9):1327-1329.AJ

Abstract

BACKGROUND

Staten Island University Hospital is located in NYC, where the opioid epidemic has resulted in significant mortalities from unintentional overdoses. In 2013 as a response to the rising threat to our community, our Emergency Department (ED) administration adopted a clinical practice policy focused on decreasing the prescription of controlled substances. The effects of this policy on our provider prescription patterns are presented here.

METHODS

A retrospective chart review of patients prescribed opioids from the ED before and after policy implementation was performed. Dates chosen for analysis was November 1, 2012 through January 31, 2013 and November 1, 2013 through January 31, 2014; these time periods were used to serve as a seasonally comparative group pre and post clinical practice policy implementation. Opioids written for the treatment of cough, and for children under eighteen were excluded from analysis. Patient age, sex, diagnoses, and prescription formulation, strength, and pill number was recorded for each patient receiving an opioid prescription.

RESULTS

There was a drop in the total prescriptions from 1756 to 1128 without a change in the average number of pills (12.78 vs 12.44) or average total dose prescribed (69.39 vs 68.98) mg of morphine equivalent per prescription. Additionally, there were sizable reductions in opioid prescriptions written for arthralgias/myalgias, dental pain, soft tissue injuries, and headaches.

CONCLUSION

The opioid clinical policy had a clear effect in decreasing the number of patients prescribed opioids. Such policies may be the key to reducing the epidemic and saving lives from unintentional opioid overdoses.

Authors+Show Affiliations

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY, United States. Electronic address: jchacko3@northwell.edu.Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY, United States.Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY, United States.Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY, United States.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28663006

Citation

Chacko, Jerel, et al. "Effect of an Emergency Department Opioid Prescription Policy On Prescribing Patterns." The American Journal of Emergency Medicine, vol. 35, no. 9, 2017, pp. 1327-1329.
Chacko J, Greenstein J, Ardolic B, et al. Effect of an emergency department opioid prescription policy on prescribing patterns. Am J Emerg Med. 2017;35(9):1327-1329.
Chacko, J., Greenstein, J., Ardolic, B., & Berwald, N. (2017). Effect of an emergency department opioid prescription policy on prescribing patterns. The American Journal of Emergency Medicine, 35(9), 1327-1329. https://doi.org/10.1016/j.ajem.2017.06.024
Chacko J, et al. Effect of an Emergency Department Opioid Prescription Policy On Prescribing Patterns. Am J Emerg Med. 2017;35(9):1327-1329. PubMed PMID: 28663006.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of an emergency department opioid prescription policy on prescribing patterns. AU - Chacko,Jerel, AU - Greenstein,Josh, AU - Ardolic,Brahim, AU - Berwald,Nicole, Y1 - 2017/06/15/ PY - 2017/03/05/received PY - 2017/06/09/revised PY - 2017/06/10/accepted PY - 2017/7/1/pubmed PY - 2017/9/8/medline PY - 2017/7/1/entrez SP - 1327 EP - 1329 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 35 IS - 9 N2 - BACKGROUND: Staten Island University Hospital is located in NYC, where the opioid epidemic has resulted in significant mortalities from unintentional overdoses. In 2013 as a response to the rising threat to our community, our Emergency Department (ED) administration adopted a clinical practice policy focused on decreasing the prescription of controlled substances. The effects of this policy on our provider prescription patterns are presented here. METHODS: A retrospective chart review of patients prescribed opioids from the ED before and after policy implementation was performed. Dates chosen for analysis was November 1, 2012 through January 31, 2013 and November 1, 2013 through January 31, 2014; these time periods were used to serve as a seasonally comparative group pre and post clinical practice policy implementation. Opioids written for the treatment of cough, and for children under eighteen were excluded from analysis. Patient age, sex, diagnoses, and prescription formulation, strength, and pill number was recorded for each patient receiving an opioid prescription. RESULTS: There was a drop in the total prescriptions from 1756 to 1128 without a change in the average number of pills (12.78 vs 12.44) or average total dose prescribed (69.39 vs 68.98) mg of morphine equivalent per prescription. Additionally, there were sizable reductions in opioid prescriptions written for arthralgias/myalgias, dental pain, soft tissue injuries, and headaches. CONCLUSION: The opioid clinical policy had a clear effect in decreasing the number of patients prescribed opioids. Such policies may be the key to reducing the epidemic and saving lives from unintentional opioid overdoses. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/28663006/Effect_of_an_emergency_department_opioid_prescription_policy_on_prescribing_patterns_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(17)30468-0 DB - PRIME DP - Unbound Medicine ER -