Randomized Controlled Trial of Electronic Care Plan Alerts and Resource Utilization by High Frequency Emergency Department Users with Opioid Use Disorder

The Western Journal of Emergency Medicine
Niels RathlevPaul Visintainer

Abstract

There is a paucity of literature supporting the use of electronic alerts for patients with high frequency emergency department (ED) use. We sought to measure changes in opioid prescribing and administration practices, total charges and other resource utilization using electronic alerts to notify providers of an opioid-use care plan for high frequency ED patients. This was a randomized, non-blinded, two-group parallel design study of patients who had 1) opioid use disorder and 2) high frequency ED use. Three affiliated hospitals with identical electronic health records participated. Patients were randomized into "Care Plan" versus "Usual Care groups". Between the years before and after randomization, we compared as primary outcomes the following: 1) opioids (morphine mg equivalents) prescribed to patients upon discharge and administered to ED and inpatients; 2) total medical charges, and the numbers of; 3) ED visits, 4) ED visits with advanced radiologic imaging (computed tomography [CT] or magnetic resonance imaging [MRI]) studies, and 5) inpatient admissions. A total of 40 patients were enrolled. For ED and inpatients in the "Usual Care" group, the proportion of morphine mg equivalents received in the post-period compared with...Continue Reading

Citations

Aug 22, 2018·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Hannah J KimmelMegan L Ranney
Feb 8, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Charles K WongEddy Lang
Jan 27, 2019·Journal of Orthopaedic Trauma·Joseph R HsuUNKNOWN Orthopaedic Trauma Association Musculoskeletal Pain Task Force
Dec 11, 2020·The Journal of Emergency Medicine·Brett ToddRonny Otero
Oct 18, 2020·The American Journal of Emergency Medicine·Fariba AghajafariJoanna Abraham
Jul 10, 2009·The Cochrane Database of Systematic Reviews·Kaveh G ShojaniaJeremy Grimshaw

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