Impact of prescription drug-monitoring program on controlled substance prescribing in the ED

McAllister, Matthew W.; Aaronson, Patrick; Spillane, Joe; Schreiber, Mark; Baroso, Genelyn; Kraemer, Dale F.; Smotherman, Carmen; Gray-Eurom, Kelly

doi:10.1016/j.ajem.2015.03.036

Cited by 35 publications

(64 citation statements)

References 6 publications

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“…Fifteen interventions involved surgical inpatients, 3 were implemented in the intensive care unit, 7 were conducted in the ED, 5 involved geriatric inpatients (≥65 years), and the remaining 7 studies were conducted in all inpatients, and those receiving patient‐controlled analgesia (PCA) or transdermal fentanyl …”

Section: Resultsmentioning

confidence: 99%

“…Risk of bias assessment was performed for 4 RCTs and 33 nonrandomised studies (). Out of the 31 articles in which opioid use was evaluated as a primary outcome, 24 studies were graded as having either a moderate or serious risk of bias, largely due to confounding or selection of participants into the study . A moderate or serious risk of bias was found in 3 of 6 studies in which opioid use was addressed as a secondary outcome .…”

Section: Resultsmentioning

confidence: 99%

“…Five studies used tools to guide the appropriate prescribing of opioids . A pain assessment tool was used in 1 study, which did not report a significant difference in the quantity of opioids used …”

Section: Resultsmentioning

confidence: 99%

“…56 The interventions were performed in various countries worldwide, with the majority, 14, conducted in the USA (Tables 1-4). [20][21][22][23]25,29,31,40,41,50,52,[54][55][56] Due to variability in study type and interventions employed, we summarised the review according to intervention type.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Out of the 31 articles in which opioid use was evaluated as a primary outcome, 24 studies were graded as having either a moderate or serious risk of bias, largely due to confounding or selection of participants into the study. [21][22][23][24][26][27][28][30][31][32][35][36][37][39][40][41][42][43][44]50,52,[54][55][56] A moderate or serious risk of bias was found in 3 of 6 studies in which opioid use was addressed as a secondary outcome. 33,34,48 Selective reporting of outcomes and other risk of bias were unclear in most studies.…”

Section: Quality Assessmentmentioning

confidence: 99%

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Effectiveness of interventions on the appropriate use of opioids for noncancer pain among hospital inpatients: A systematic review

Liu

Gnjidic

Nguyen

et al. 2020

Brit J Clinical Pharma

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Aims To summarise the effectiveness of interventions on appropriate opioid use for noncancer pain among hospital inpatients. Methods Two reviewers independently searched 6 databases up to March 2018 original research articles reporting on quantitative outcomes of interventions on appropriate opioid use among hospital inpatients. Appropriate opioid use was measured by changes in prescribing, such as the lowest effective opioid dose and duration, or clinical outcomes such as adequate pain control. Quality and intervention complexity assessments were performed by 2 independent reviewers. The full methodological approach was published on PROSPERO (ID: CRD42019145947). Results Of 398 full‐text articles assessed for eligibility, 37 articles were included in the review. Most articles had a moderate or high risk of bias (27 of 37 studies). Thirty‐one articles primarily addressed appropriate opioid use and 6 articles targeted opioid safety as a secondary outcome. A multifaceted approach was the most common primary intervention (16 studies) and adequate pain control was the main outcome measured (14 studies). Health provider education, reinforced by hard‐copy material and feedback, was associated with a 13.0 to 29.5% increase in the proportion of opioid prescriptions written in concordance with local guidelines and reduced pain scores ranging from 7.0 to 34.5%. Interventions to improve opioid safety in patient‐controlled analgesia reduced medication errors by up to 89.1%. Conclusion Interventions involving academic detailing and education, especially when reinforced by feedback, show positive effects on appropriate opioid use among hospital inpatients. Future studies investigating the impact of administrative interventions on opioid use and related outcomes are warranted.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness of interventions on the appropriate use of opioids for noncancer pain among hospital inpatients: A systematic review

Liu

Gnjidic

Nguyen

et al. 2020

Brit J Clinical Pharma

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Evaluation of Interventions to Reduce Opioid Prescribing for Patients Discharged From the Emergency Department

et al. 2022

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Key Points Question Are interventions to reduce pain-related opioid prescribing for patients who are discharged from the emergency department associated with variation in opioid prescription rate and/or prescribed opioid quantity? Findings In this meta-analysis of 63 unique studies, 34 of 51 studies assessing prescribing rates (67%) reported a significant reduction after intervention implementation, and 17 of the 39 studies assessing prescribed opioid quantity (44%) reported a significant intervention-related reduction. There were no data on patient-centered outcomes such as pain relief. Meaning This analysis found that specific interventions may be associated with reducing the opioid prescription rate; however, novel interventions are needed to reduce the quantity of opioids per prescription by emergency department physicians while evaluating their associations with patient-centered outcomes.

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Informatics

Dadabhoy,

Marshall,

Landman

2023

An Emergency Physician’s Path

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Impact of prescription drug-monitoring program on controlled substance prescribing in the ED

Cited by 35 publications

References 6 publications

Effectiveness of interventions on the appropriate use of opioids for noncancer pain among hospital inpatients: A systematic review

Effectiveness of interventions on the appropriate use of opioids for noncancer pain among hospital inpatients: A systematic review

Evaluation of Interventions to Reduce Opioid Prescribing for Patients Discharged From the Emergency Department

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