A Performance Improvement Prescribing Guideline Reduces Opioid Prescriptions for Emergency Department Dental Pain Patients - 20/08/13
, Sandra Stevens, MD, Tracy Tippie, MD
Address for correspondence: James Li, MDRésumé |
Study objective |
In an effort to reduce prescription opioid abuse originating from our institution, we implement and measure the effect of a prescribing guideline on the rate of emergency department (ED) opioid prescriptions written for patients presenting with dental pain, a complaint previously associated with drug-seeking behavior.
Methods |
After implementing a departmental guideline on controlled substance prescriptions, we performed a structured before-and-after chart review of dental pain patients aged 16 and older.
Results |
Before the guideline, the rate of opioid prescription was 59% (302/515). After implementation, the rate was 42% (65/153). The absolute decrease in rates was 17% (95% confidence interval 7% to 25%). Additionally, in comparing the 12-month period before and after implementation, the dental pain visit rate decreased from 26 to 21 per 1,000 ED visits (95% confidence interval of decrease 2 to 9 visits/1,000).
Conclusion |
A performance improvement program involving a departmental prescribing guideline was associated with a reduction in the rate of opioid prescriptions and visits for ED patients presenting with dental pain.
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| Please see page 238 for the Editor's Capsule Summary of this article. |
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| Supervising editor: Lewis S. Nelson, MD |
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| Author contributions: TRF and JL conceived the performance improvement project and wrote the prescription guideline. SS and TT conducted the chart review. JL designed and supervised the chart review, performed the data analysis, was responsible for statistical reporting, and wrote the initial article. All authors contributed to its revision. JL takes responsibility for the paper as a whole. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist. |
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| Publication date: Available online January 30, 2013. |
Vol 62 - N° 3
P. 237-240 - septembre 2013 Retour au numéro
Article précédent
- The Trouble With Medication Adherence After Emergency Care
- Brian Suffoletto, Donald M. Yealy
- Centering the Pendulum: The Evolution of Emergency Medicine Opioid Prescribing Guidelines
- Scott G. Weiner, Jeanmarie Perrone, Lewis S. Nelson
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