Association of Electronic Prescribing of Controlled Substances With Opioid Prescribing Rates

Abstract

Key Points Question Have states with greater increases in electronic prescribing of controlled substances (EPCS), which is intended to reduce opioid prescribing rates by reducing fraud and facilitating decision support, experienced greater reductions in opioid prescribing? Findings In this longitudinal analysis of Surescripts reports on the use of EPCS and Center of Disease Prevention and Control opioid prescribing rate maps, increasing the use of EPCS by 10 percentage points was associated with 2 more opioid prescriptions per 100 persons and 0.8% more morphine milligram equivalents. Meaning The EPCS has not been associated with reductions in opioid prescribing rates, and achieving benefit may require greater integration and effective presentation of data.

The Effect of an Electronic Prescribing Policy for Opioids on Physician Prescribing Patterns Following Common Upper Extremity Procedures

“…6e10,19e21 Although the advent of ePrescribing of controlled substances is thought to potentially increase patient safety by eliminating opioid diversion, curbing prescription fraud, and decreasing overprescribing, the effect of ePrescribing regulations on physicians' patterns of opioid prescribing has not yet been reported in our literature. 15 This study demonstrates that the initiation of ePrescribing of narcotics significantly changed hand/upper extremity physicians' opioid prescribing patterns at our institution. For CMC arthroplasty, ganglion excision, and DRF ORIF, the implementation of an ePrescribing protocol led to a decrease in the total number of opioid tablets prescribed and a decrease in the total MMEs prescribed for ganglion excision and CMC arthroplasty.…”

“…Further, when all patientsdregardless of the proceduredwere considered together, the average total MMEs prescribed per patient per procedure prior to the institution of ePrescribing was significantly greater than the average total MMEs prescribed after the institution of ePrescribing (155 [SD, 134] vs 128 [SD, 108], P ¼ .01). Additionally, across all patients, the average total number of tablets prescribed per patient per procedure for the prepolicy group significantly differed from that prescribed for the postpolicy group (21 [SD,15] vs 17 [SD, 14], P < .01).…”

“… 6 , 7 , 8 , 9 , 10 , 19 , 20 , 21 Although the advent of ePrescribing of controlled substances is thought to potentially increase patient safety by eliminating opioid diversion, curbing prescription fraud, and decreasing overprescribing, the effect of ePrescribing regulations on physicians’ patterns of opioid prescribing has not yet been reported in our literature. 15 …”

“…Although 1 study across all of health care broadly did not find a relationship between opioid ePrescribing requirements and a decreased number of prescriptions and morphine milligram equivalents (MMEs), more specific evaluation of such a policy on opioid prescribing patterns within hand surgery is lacking. 15 This study evaluates opioid prescription patterns by hand surgeons following the advent of an ePrescribing policy. Specifically, we aimed to answer the following question: is there a change in the number of opioids prescribed after the institution of electronic opioid prescriptions in 4 common, yet diverse, outpatient hand surgeries: carpal tunnel release (CTR), ganglion excision, distal radius fracture (DRF) open reduction internal fixation (ORIF), and carpometacarpal (CMC) arthroplasty?…”

“…Although 1 study across all of health care broadly did not find a relationship between opioid ePrescribing requirements and a decreased number of prescriptions and morphine milligram equivalents (MMEs), more specific evaluation of such a policy on opioid prescribing patterns within hand surgery is lacking. 15 …”