• Ann Emerg Med · May 2022

    Opioid Prescription Reduction After Implementation of a Feedback Program in a National Emergency Department Group.

    • Jonathan J Oskvarek, Amer Aldeen, Jason Shawbell, Arvind Venkat, Mark S Zocchi, Jesse M Pines, and US Acute Care Solutions Research Group.
    • US Acute Care Solutions, Canton, OH; Department of Emergency Medicine, Summa Health System, Akron, OH. Electronic address: Oskvarekj@usacs.com.
    • Ann Emerg Med. 2022 May 1; 79 (5): 420-432.

    Study ObjectiveReducing excessive opioid prescribing in emergency departments (ED) may prevent opioid addiction. We evaluated the largest personalized feedback and peer comparison intervention to date on emergency clinician opioid prescription rates in a national emergency clinician group.MethodsThis interrupted time series analysis of a quality improvement intervention included data from adults discharged from 102 EDs in 17 states from January 1, 2019, to July 31, 2021. From June 16, 2020, to November 30, 2020, site-level ED directors received emails on local opioid prescription rates. From December 1, 2020, to July 31, 2021, all clinicians were granted electronic dashboard access, which showed prescription rates compared with peers, and national ED leaders sent emails to high-prescribing clinicians and engaged in one-on-one conversations. The primary outcome was opioid prescriptions per 100 discharges.ResultsThe study included 5,328,288 ED discharges from 924 physicians and 472 advanced practice providers. Opioid prescription rates did not change meaningfully in the site-level director feedback period (mean difference = -0.3, 95% confidence interval [CI] -0.6 to -0.1). During the direct clinician feedback period, opioid prescription rates declined from 10.4 per 100 discharges to 8.4 per 100 discharges (mean difference = -2.0, 95% CI -2.4 to -1.5), a 19% relative reduction. Among prescribers in the highest initial quintile, opioid prescribing reduced by 35% among physicians and 41% among advanced practice providers in the direct feedback period.ConclusionWe demonstrated a large, sustained reduction in opioid prescribing by emergency clinicians using direct, personalized feedback to clinicians and an electronic dashboard for peer comparison.Copyright © 2021 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…