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Lower default amount of opioid pills in electronic medical record may reduce opioid prescribing

July 18, 2018

Bottom Line: Lowering the default amount of opioid pills prescribed to patients in a health care system's electronic medical record was associated with a deccrease in the amount of opioids prescribed systemwide.

Why The Research Is Interesting: Numerous attempts have been made to change the culture of opioid prescribing. One potential approach is changing the computerized clinician order entry systems in electronic medical record (EMR) systems. In these systems, prescriptions for opioids can autopopulate with a default number of pills prescribed.

What (Study Intervention and Outcomes) and When: Default number of opioid pills lowered in a health care system's EMR from 30 to 12 in 2017 (intervention); change in median number of opioid pills and total dose prescribed postoperatively before and after the default number of opioid pills was changed.

How (Study Design): This before-and-after study compared postoperative prescribing patterns for 1,447 surgical procedures during three months before the default number of opioid pills was lowered with 1,463 procedures during three months after the change

Authors: Alexander S. Chiu, M.D., Yale School of Medicine, New Haven, Connecticut, and coauthors

Study Limitations: Study reflects the experience of a single health system; unclear if the results can be reproduced at other institutions; long-term follow-up is needed; and unaccounted factors could have influenced the change in prescribing patterns.

Related material: The commentary, "How to Combat the Opioid Epidemic, 1 Nudge at a Time," by Nancy N. Baxter, M.D., Ph.D., University of Toronto, and coauthors is also available on the For The Media website.

To Learn More: The full study is available on the For The Media website.


Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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JAMA Surgery

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