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Title: Modifying emergency department electronic prescribing for outpatient opioid analgesia.
Austin Authors: Schwartz, Grace D;Harding, Andrew M ;Donaldson, Síne R;Greene, Shaun L 
Affiliation: Department of Clinical Toxicology, Austin Health, Heidelberg, Victoria, Australia
Department of Emergency Medicine, Austin Health, Heidelberg, Victoria, Australia
Pharmacy Department, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 2019
Date: 2018-12-03
Publication information: Emergency Medicine Australasia : EMA: EMA 2019; 31(3): 417-422
Abstract: The aim of this study was to examine how changing the electronic ordering sequences for opioid analgesics affected ED outpatient prescribing, and subsequent unused opioid tablets remaining in the community available for diversion. A descriptive before and after study in adult patients prescribed an opioid analgesic by an ED prescriber for use in the outpatient setting. The hospital electronic prescribing system (FirstNet™) was modified to include smaller quantities of opioid analgesics for discharge. The change in quantity of opioid prescribed and change in quantity of opioid analgesic remaining in the community at follow up was measured pre- and post-intervention using a structured telephone interview. Pre- and post-intervention, 102 and 106 patients were interviewed, respectively. Percentage of prescriptions for oxycodone quantity five tablets increased from 3% to 32% and for quantity 20 tablets fell from 40% to 24% post-intervention. For paracetamol with codeine, prescriptions for quantity 10 tablets increased from 2% to 24% while for quantity 20 tablets fell from 98% to 76%. Mean number of tablets prescribed per patient fell from 13.8 (SD = 5.1) to 10.8 (SD = 5.6) for oxycodone and from 19.8 (SD = 1.5) to 17.6 (SD = 4.2) for paracetamol with codeine. Fifty-eight percent of patients in both pre- and post-intervention groups used half or less of the medication prescribed. Modification of an ED electronic prescribing system reduced overall quantities of opioid analgesics supplied and subsequently stored in the community but did not change the proportion of patients (>50%) who reported using half or less of their prescribed opioid medication.
DOI: 10.1111/1742-6723.13192
ORCID: 0000-0002-1339-3232
Journal: Emergency Medicine Australasia : EMA
PubMed URL: 30508874
Type: Journal Article
Subjects: analgesics
electronic prescribing
emergency medicine
Appears in Collections:Journal articles

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