Effect of New York State Electronic Prescribing Mandate on Opioid Prescribing Patterns.


Journal

The Journal of emergency medicine
ISSN: 0736-4679
Titre abrégé: J Emerg Med
Pays: United States
ID NLM: 8412174

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 12 06 2018
revised: 17 03 2019
accepted: 30 03 2019
pubmed: 2 7 2019
medline: 17 6 2020
entrez: 2 7 2019
Statut: ppublish

Résumé

Drug overdose was the leading cause of injury and death in 2013, with drug misuse and abuse causing approximately 2.5 million emergency department (ED) visits in 2011. The Electronic Prescriptions for Controlled Substances (EPCS) program was created with the goal of decreasing rates of prescription opioid addiction, abuse, diversion, and death by making it more difficult to "doctor-shop" and alter prescriptions. In this study, we describe the opioid-prescribing patterns of emergency physicians after the introduction of the New York State EPCS mandate. We conducted a retrospective, single-center, descriptive study with a pre-/post-test design. The pre-implementation period used for comparison was April 1-July 31, 2015 and the post-implementation period was April 1-July 31, 2016. All ED discharge prescriptions for opioid medications prior to and after the initiation of New York State EPCS were identified. During the pre-implementation study period, 22,221 patient visits were identified with 1366 patients receiving an opioid prescription. During the post-implementation study period, 22,405 patient visits were identified with 642 patients receiving an opioid prescription. This represented an absolute decrease of 724 (53%) opioid prescriptions (p < 0.0001), which is an absolute difference of 2.3% (95% confidence interval 2.0-2.6%). There was a significant decline in the overall number of opioid prescriptions after implementation of the New York EPCS mandate.

Sections du résumé

BACKGROUND BACKGROUND
Drug overdose was the leading cause of injury and death in 2013, with drug misuse and abuse causing approximately 2.5 million emergency department (ED) visits in 2011. The Electronic Prescriptions for Controlled Substances (EPCS) program was created with the goal of decreasing rates of prescription opioid addiction, abuse, diversion, and death by making it more difficult to "doctor-shop" and alter prescriptions.
OBJECTIVE OBJECTIVE
In this study, we describe the opioid-prescribing patterns of emergency physicians after the introduction of the New York State EPCS mandate.
METHODS METHODS
We conducted a retrospective, single-center, descriptive study with a pre-/post-test design. The pre-implementation period used for comparison was April 1-July 31, 2015 and the post-implementation period was April 1-July 31, 2016. All ED discharge prescriptions for opioid medications prior to and after the initiation of New York State EPCS were identified.
RESULTS RESULTS
During the pre-implementation study period, 22,221 patient visits were identified with 1366 patients receiving an opioid prescription. During the post-implementation study period, 22,405 patient visits were identified with 642 patients receiving an opioid prescription. This represented an absolute decrease of 724 (53%) opioid prescriptions (p < 0.0001), which is an absolute difference of 2.3% (95% confidence interval 2.0-2.6%).
CONCLUSIONS CONCLUSIONS
There was a significant decline in the overall number of opioid prescriptions after implementation of the New York EPCS mandate.

Identifiants

pubmed: 31256931
pii: S0736-4679(19)30259-8
doi: 10.1016/j.jemermed.2019.03.052
pii:
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

156-161

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Dimitry Danovich (D)

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York.

Josh Greenstein (J)

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York.

Jerel Chacko (J)

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York.

Barry Hahn (B)

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York.

Brahim Ardolic (B)

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York.

Ben Ilyaguyev (B)

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York.

Nicole Berwald (N)

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York.

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Classifications MeSH