STUDY OBJECTIVE: In an effort to reduce prescription opioid abuse originating from our institution, we implement and measure the effect of a prescribing guideline on the rate of emergency department (ED) opioid prescriptions written for patients presenting with dental pain, a complaint previously associated with drug-seeking behavior. METHODS: After implementing a departmental guideline on controlled substance prescriptions, we performed a structured before-and-after chart review of dental pain patients aged 16 and older. RESULTS: Before the guideline, the rate of opioid prescription was 59% (302/515). After implementation, the rate was 42% (65/153). The absolute decrease in rates was 17% (95% confidence interval 7% to 25%). Additionally, in comparing the 12-month period before and after implementation, the dental pain visit rate decreased from 26 to 21 per 1,000 ED visits (95% confidence interval of decrease 2 to 9 visits/1,000). CONCLUSION: A performance improvement program involving a departmental prescribing guideline was associated with a reduction in the rate of opioid prescriptions and visits for ED patients presenting with dental pain.
STUDY OBJECTIVE: In an effort to reduce prescription opioid abuse originating from our institution, we implement and measure the effect of a prescribing guideline on the rate of emergency department (ED) opioid prescriptions written for patients presenting with dental pain, a complaint previously associated with drug-seeking behavior. METHODS: After implementing a departmental guideline on controlled substance prescriptions, we performed a structured before-and-after chart review of dental painpatients aged 16 and older. RESULTS: Before the guideline, the rate of opioid prescription was 59% (302/515). After implementation, the rate was 42% (65/153). The absolute decrease in rates was 17% (95% confidence interval 7% to 25%). Additionally, in comparing the 12-month period before and after implementation, the dental pain visit rate decreased from 26 to 21 per 1,000 ED visits (95% confidence interval of decrease 2 to 9 visits/1,000). CONCLUSION: A performance improvement program involving a departmental prescribing guideline was associated with a reduction in the rate of opioid prescriptions and visits for ED patients presenting with dental pain.
Authors: Austin S Kilaru; Jeanmarie Perrone; Catherine L Auriemma; Frances S Shofer; Frances K Barg; Zachary F Meisel Journal: Acad Emerg Med Date: 2014-03 Impact factor: 3.451
Authors: Christopher Okunseri; Raymond A Dionne; Sharon M Gordon; Elaye Okunseri; Aniko Szabo Journal: Drug Alcohol Depend Date: 2015-09-28 Impact factor: 4.492
Authors: Zachary F Meisel; Joshua P Metlay; Lauren Sinnenberg; Austin S Kilaru; Anne Grossestreuer; Frances K Barg; Frances S Shofer; Karin V Rhodes; Jeanmarie Perrone Journal: Ann Emerg Med Date: 2016-04-29 Impact factor: 5.721
Authors: Austin S Kilaru; Sarah M Gadsden; Jeanmarie Perrone; Breah Paciotti; Frances K Barg; Zachary F Meisel Journal: Ann Emerg Med Date: 2014-04-16 Impact factor: 5.721