Lowering default number of pills can reduce prescribed opioids

(HealthDay)—Reducing the default number of opioid pills prescribed in an electronic medical record (EMR) system can effectively decrease the amount of opioids prescribed after procedures, according to a study published online July 18 in JAMA Surgery.

Alexander S. Chiu, M.D., from the Yale School of Medicine in New Haven, Conn., and colleagues conducted a pre-post intervention study to compare postprocedural prescribing patterns during the three months before and after lowering the default number of pills presented when prescribing opioids in an EMR system. Data were included for 1,447 procedures before the default change and 1,463 after the default change.

The researchers found that the median number of opioid pills decreased from 30 to 20 per prescription after the default change. There was a decrease in the percentage of prescriptions written for 30 pills from 39.7 percent before to 12.9 percent after the default change and an increase in the percentage of prescriptions written for 12 pills, from 2.1 to 24.6 percent. After the default change, there was a decrease of 5.22 opioid pills per prescription; per prescription there was a decrease of 34.41 morphine milligram equivalents.

"Lowering the default number of opioid pills prescribed in an EMR system is a simple, effective, cheap, and potentially scalable intervention to change prescriber behavior and decrease the amount of opioid medication prescribed after procedures," the authors write.

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