Opioid prescribing and adverse events in opioid-naive patients treated by emergency physicians versus family physicians: a population-based cohort study

Clinical Innovation Poster Abstracts

“…4,5 Clinical practice guidelines emphasize non-pharmacological management of pain as the first line approach for chronic non-cancer pain including MSK conditions. 6,7 However, cost presents a significant barrier for those without public or private insurance. Furthermore, OW recipients currently do not receive job-related pain or functional ability assessment by a healthcare professional as part of their employment readiness planning.…”

“…In addition, 83% of Ontario patients seen in the government-funded Primary Care Low Back Pain Clinics report requiring less medications after seeing an MSK expert 6 . Despite these recommendations, low back pain is the top reason for initial opioid prescription in Ontario's family practices and emergency departments 7 .…”

Impact of an emergency department opioid prescribing guideline on emergency physician behaviour and incidence of overdose in the Saskatoon Health Region: a retrospective pre–post implementation analysis

“…1,2 In British Columbia, there were 374 fentanyl-related overdose deaths between January and October 2016, an increase of 194% over the same period in 2015. 3 Acute care centres and emergency departments have been proposed as potential drivers of this epidemic, [4][5][6][7] including in a recent longitudinal study in Ontario that showed that patients who received opioid prescriptions in the emergency department had a higher risk of admission for opioid toxicity over 2 years. 5 With its high patient volume and lack of a preexisting patientprovider relationship, the emergency department has been identified as a possible location where opioid use disorders may develop, with upward of 29% of those misusing opioids having been initially exposed in this setting.…”

“…3 Acute care centres and emergency departments have been proposed as potential drivers of this epidemic, [4][5][6][7] including in a recent longitudinal study in Ontario that showed that patients who received opioid prescriptions in the emergency department had a higher risk of admission for opioid toxicity over 2 years. 5 With its high patient volume and lack of a preexisting patientprovider relationship, the emergency department has been identified as a possible location where opioid use disorders may develop, with upward of 29% of those misusing opioids having been initially exposed in this setting. [5][6][7] The number of opioids prescribed during emergency depart-ment visits in the United States rose substantially over 2001-2010 and continues to trend upward.…”

“…5 With its high patient volume and lack of a preexisting patientprovider relationship, the emergency department has been identified as a possible location where opioid use disorders may develop, with upward of 29% of those misusing opioids having been initially exposed in this setting. [5][6][7] The number of opioids prescribed during emergency depart-ment visits in the United States rose substantially over 2001-2010 and continues to trend upward. 8 The increase in opioid prescriptions has been attributed to numerous factors including aggressive marketing by pharmaceutical companies, the desire to minimize acute and chronic pain, and a lack of discussion between prescribers and patients…”