Reduction of Parenteral Opioid Use in Community Emergency Departments Following Implementation of Treatment Guidelines

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Ali GhobadiAdam L Sharp

Abstract

Opioid prescribing guidelines are commonly seen as part of the solution to America's opioid epidemic. However, the effectiveness of specific treatment guidelines on altering opioid prescribing in the emergency department (ED) is unclear. We examined provider ordering patterns before and after implementation of opioid use guidelines for ED patients overall and the specific subsets of ED patients with either chronic opioid use or fracture. We conducted a pre-post interrupted time series analysis of adult (≥18 years old) ED encounters in 14 integrated community EDs before (2013) and after (2014) the implementation of opioid prescribing guidelines. We compared opioid use pre- and postintervention using segmented logistic regression for primary and secondary analyses. The primary outcome was parenteral opioid use in the ED, with additional subgroup analysis of chronic pain and fracture cohorts. We also examined ED oral opioid use and discharge prescribing. There were 508,337 pre- and 531,620 postintervention encounters. The intervention was associated with an initial reduction in the odds of parenteral opioids ordered (odds ratio [OR] = 0.89, 95% CI = 0.87-0.91) and a decrease in the monthly trend compared to the preintervention per...Continue Reading

References

Jan 5, 2010·Annals of Emergency Medicine·David F BaehrenPeter Akpunonu
Apr 7, 2011·JAMA : the Journal of the American Medical Association·Nora D VolkowSusan R B Weiss
Oct 12, 2012·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Darin E NevenRussell J Carlisle
Feb 25, 2014·The American Journal of Emergency Medicine·Hsien-Yen ChangG Caleb Alexander
Mar 19, 2014·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Maryann Mazer-AmirshahiJesse M Pines
Dec 24, 2014·Annals of Emergency Medicine·Jason A HoppeKennon Heard
Jun 28, 2015·Neuroscience and Biobehavioral Reviews·Florence AllainAnne-Noël Samaha
Aug 19, 2015·The Journal of Emergency Medicine·Daniel A del PortalRobert M McNamara
Oct 20, 2015·The American Journal of Emergency Medicine·Roneet LevChristopher J Coyne
Feb 15, 2016·Annals of Emergency Medicine·Megan M ButlerMichael S Lyons
Mar 18, 2016·MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports·Deborah DowellRoger Chou
Jun 16, 2016·Journal of Pain & Palliative Care Pharmacotherapy· Centers For Disease Control And Prevention Public Health Service U S Department Of Health And Human Services
Dec 30, 2016·MMWR. Morbidity and Mortality Weekly Report·Rose A RuddLawrence Scholl
Jan 24, 2017·The Journal of Emergency Medicine·Scott R OsbornC Craig Blackmore
Feb 16, 2017·The New England Journal of Medicine·Michael L BarnettAnupam B Jena
May 26, 2017·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Benjamin C SunK John McConnell

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Citations

Jan 5, 2021·Journal of the American College of Emergency Physicians Open·James D MaloyDavid A Berger
Jul 30, 2021·Journal of the American College of Emergency Physicians Open·Cindy D ChangUNKNOWN ACEP Pediatric Emergency Medicine Committee

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