|February 19, 2018
Use EMR System Defaults to Reduce Opioid Prescribing
Researchers at the University of Pennsylvania in Philadelphia noticed a problem with overprescribing of opioids in their emergency departments. Many patients were not talking nearly as many opioid pills as they were being prescribed. As the institution changed its EMR provider, Dr. M. Kit Delgado and others took advantage of a feature in the new system that allowed them to set a default number of recommended doses right in the system. They set the default to half the number of pills generally prescribed in their departments, 10 as opposed to 20. The individual prescriber remained free to prescribe whatever number she or he deemed clinically appropriate.
The effect was dramatic. After 41 weeks, the number of physicians prescribing 20 doses declined from 22.8% to 16.1%. Prescriptions for 10 doses increased from 20.6% to 43.3%. The number of prescribers ordering 11 to 19 doses also decreased, from 33.5% to 20.1%. Dr. Delgado noted that the number of prescriptions for fewer than 10 doses declined, though, as more physicians followed the default recommendation.
The researchers tweaked the system to provide for defaults of different opioid/acetominophen combinations and including options for different numbers of doses. They found that the number of opioid doses being prescribed was cut in half, with patients reporting fewer pills left over after their pain resolved.< Previous Article | Next Article >
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