Author(s): Fox TR, Li J, Stevens S, Tippie T
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Abstract 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. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.
This article was published in Ann Emerg Med
and referenced in Journal of Pain Management & Medicine