Association of Lowering Default Pill Counts in Electronic Medical Record Systems With Postoperative Opioid Prescribing

JAMA Surgery
Alexander S ChiuKevin Y Pei

Abstract

Reliance on prescription opioids for postprocedural analgesia has contributed to the opioid epidemic. With the implementation of electronic medical record (EMR) systems, there has been increasing use of computerized order entry systems for medication prescriptions, which is now more common than handwritten prescriptions. The EMR can autopopulate a default number of pills prescribed, and 1 potential method to alter prescriber behavior is to change the default number presented via the EMR system. To investigate the association of lowering the default number of pills presented when prescribing opioids in an EMR system with the amount of opioid prescribed after procedures. A prepost intervention study was conducted to compare postprocedural prescribing patterns during the 3 months before the default change (February 18 to May 17, 2017) with the 3 months after the default change (May 18 to August 18, 2017). The setting was a multihospital health care system that uses Epic EMR (Hyperspace 2015 IU2; Epic Systems Corporation). Participants were all patients in the study period undergoing 1 of the 10 most common operations and discharged by postoperative day 1. The default number of opioid pills autopopulated in the EMR when prescribing...Continue Reading

References

Dec 23, 2004·Transplantation·Eric J Johnson, Daniel G Goldstein
Sep 27, 1974·Science·A Tversky, D Kahneman
Dec 11, 2008·JAMA : the Journal of the American Medical Association·A Thomas McLellan, Barbara Turner
Dec 17, 2009·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Marla Z WolfertJames F Cleary
Jun 28, 2011·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Susan Cochella, Kim Bateman
Oct 23, 2013·Clinical Therapeutics·Natalia E Morone, Debra K Weiner
Feb 13, 2014·BMJ : British Medical Journal·Hance ClarkeDuminda N Wijeysundera
Apr 22, 2015·American Journal of Preventive Medicine·Benjamin LevyChristopher M Jones
Jan 14, 2016·The New England Journal of Medicine·Wilson M ComptonGrant T Baldwin
Mar 12, 2016·JAMA : the Journal of the American Medical Association·Lemeneh TeferaPatrick Conway
Mar 16, 2016·JAMA : the Journal of the American Medical Association·Deborah DowellRoger Chou
Mar 31, 2016·The New England Journal of Medicine·Nora D Volkow, A Thomas McLellan
Jun 23, 2016·The New England Journal of Medicine·Ellen MearaNancy E Morden
Apr 14, 2017·JAMA Surgery·Chad M BrummettBrahmajee K Nallamothu
Jul 7, 2017·MMWR. Morbidity and Mortality Weekly Report·Gery P GuyDeborah Dowell
Aug 3, 2017·JAMA Surgery·Mark C BicketChristopher L Wu

❮ Previous
Next ❯

Citations

Aug 9, 2018·The New England Journal of Medicine·Margaret LowensteinM Kit Delgado
Jun 6, 2019·The New England Journal of Medicine·Kavita M BabuDavid N Juurlink
Nov 2, 2019·JAMA Ophthalmology·Maria A WoodwardJennifer Waljee
Nov 12, 2019·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Mallika TamboliNicholas J Giori
Feb 11, 2020·International Anesthesiology Clinics·April N Smith
Jul 30, 2019·Annals of Surgery·David D Q ZhangNancy N Baxter
Sep 17, 2020·BMJ : British Medical Journal·Craig R FoxJeffrey A Linder
Mar 14, 2019·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Cynthia A KahlenbergMichael B Cross
Apr 2, 2020·JMIR Medical Informatics·Benjamin H SlovisJeffrey Riggio
Mar 19, 2019·The Western Journal of Emergency Medicine·Jeanmarie PerroneLewis S Nelson
Jun 27, 2019·JAMA : the Journal of the American Medical Association·Kevin X FarleyJohn Xerogeanes
Sep 19, 2020·Female Pelvic Medicine & Reconstructive Surgery·Shirly SoloukiNitya Elizabeth Abraham
Mar 21, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Tim TranRohan A Elliott
Jan 13, 2021·Pediatric Surgery International·Christina M TheodorouErin G Brown
Nov 9, 2018·Ophthalmic Plastic and Reconstructive Surgery·Edward J WladisArup De
Jun 15, 2020·The American Journal of Emergency Medicine·Gillian A BeauchampDavid M Richardson
Mar 25, 2021·Current Pain and Headache Reports·Stacey BurnsOscar Jim Michael Coppes
Mar 31, 2021·American Journal of Surgery·Jackly M JuprasertHeather L Yeo
Nov 9, 2019·Journal of Pediatric Surgery·Mollie R Freedman-WeissDavid H Stitelman
Apr 15, 2021·Journal of Medical Internet Research·Benjamin Heritier SlovisJohn C Kairys
Apr 27, 2021·Joint Commission Journal on Quality and Patient Safety·Adam BursuaRadhika Sreedhar
Feb 6, 2021·Australian Health Review : a Publication of the Australian Hospital Association·Champika PattulloPeter Donovan
Nov 2, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Andrew K ChangAshar Ata
Jul 7, 2021·Military Medicine·Michael S PatzkowskiKrista B Highland
Jul 14, 2021·BMJ Open·Briana S LastRinad S Beidas
Sep 7, 2020·The Journal of Surgical Research·Phillip M Kemp BohanG Travis Clifton
Aug 6, 2021·Anaesthesia and Intensive Care·Pamela E Macintyre
Sep 5, 2021·Vaccine·Paola CantarelliFilippo Quattrone
Aug 30, 2021·The International Journal on Drug Policy·Tim BoogaertsHans De Loof
Sep 5, 2021·Hernia : the Journal of Hernias and Abdominal Wall Surgery·M ReinhornUNKNOWN Abdominal Core Health Quality Collaborative Opioid Task Force*

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.