Document Type

Article

Publication Date

10-17-2020

Abstract

INTRODUCTION: Deaths have increased, and prescription medications are involved in a significant percentage of deaths. Emergency department (ED) changes to managing acute pain and prescription drug monitoring programs (PDMPs) can impact the potential for abuse.

METHODS: We analyzed the impact of a series of quality improvement initiatives on the opioid prescribing habits of emergency department physicians and advanced practice providers. We compared historical prescribing patterns with those after three interventions: 1) the implementation of a PDMP, 2) clinician education on alternatives to opioids (ALTOs), and 3) electronic health record (EHR) process changes.

RESULTS: There was a 61.8% decrease in the percentage of opioid-eligible ED discharges that received a prescription for an opioid from 19.4% during the baseline period to 7.4% during the final intervention period. Among these discharges, the cumulative effect of the interventions resulted in a 17.3% decrease in the amount of morphine milligram equivalents (MME) prescribed per discharge from a mean of 104.9 MME/discharge during the baseline period to 86.8 MME/discharge. In addition, the average amount of MME prescribed per discharge became aligned with recommended guidelines over the intervention periods.

CONCLUSIONS: Initiating a PDMP and instituting an aggressive ALTO program along with EHR-modified process flows have cumulative benefits in decreasing MME prescribed in an acute ED setting.

Comments

Sigal A, Shah A, Onderdonk A, Deaner T, Schlappy D, Barbera C. Alternatives to Opioid Education and a Prescription Drug Monitoring Program Cumulatively Decreased Outpatient Opioid Prescriptions [published online ahead of print, 2020 Oct 17]. Pain Med. 2020;pnaa278. doi:10.1093/pm/pnaa278

This is a pre-copyedited, author-produced version of an article accepted for publication in [insert journal title] following peer review. The version of record [insert complete citation information here] is available online at: xxxxxxx [insert URL and DOI of the article on the OUP website].

Available for download on Sunday, October 17, 2021

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