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Simple Tweak to Hospital Computer Program Cuts Opioid Prescriptions
  • Robert Preidt
  • Posted January 21, 2020

Simple Tweak to Hospital Computer Program Cuts Opioid Prescriptions

Could a simple computer hack help make a dent in the opioid epidemic?

New research suggests that the number of painkillers prescribed to patients can be reduced just by lowering default computer settings that display a preset number of pills.

That simple change led doctors at two California hospitals to prescribe fewer opioids, and the approach could improve opioid prescribing practices elsewhere and help prevent addiction, the researchers said.

Prescription opioids are a key part of the U.S. opioid crisis, the authors of the new study explained.

"It's striking that even in the current environment, where doctors know about the risks from opioids and are generally thoughtful about prescribing them, this intervention affected prescribing behavior," said senior author Dr. Maria Raven. She is chief of emergency medicine at the University of California, San Francisco (UCSF).

"The findings are really exciting because of their potential to impact patient care at a large level. Reducing the quantities of opioids prescribed may help protect patients from developing opioid use disorder," she said in a university news release.

For the study, Raven's team reviewed opioid prescribing in emergency departments at UCSF Medical Center and Highland Hospital in Oakland, Calif., between November 2016 and July 2017.

Over 20 weeks, the researchers randomly changed default settings on electronic medical records for commonly prescribed opioids such as oxycodone, Percocet and Norco. They tweaked the settings for four weeks at a time.

The defaults for pain medications had been 12 pills at Highland and 20 pills at UCSF. The researchers changed those to five, 10 and 15 pills, and also to a blank setting that required doctors to enter the number of pills they wanted for each patient. In all, 4,320 opioid prescriptions were analyzed.

The result: Lower defaults were associated with lower amounts of opioids prescribed and fewer orders that exceeded prescribing recommendations from the U.S. Centers for Disease Control and Prevention.

According to lead study author Dr. Juan Carlos Montoy, assistant professor of emergency medicine at UCSF, "Every electronic health record throughout the country already has default settings for opioids. What we've shown is that default settings matter, and can be changed to improve opioid prescribing."

Montoy noted that tweaking default settings doesn't cost anything and still lets doctors do what they think is best for each patient.

"The opioid epidemic is complex and this certainly won't fix it," he added. "But it is one more tool we can use to address it."

The study was published Jan. 21 in JAMA Internal Medicine.

More information

The U.S. National Institute on Drug Abuse has more about prescription opioids.

SOURCE: University of California, San Francisco, news release, Jan. 21, 2020
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