Guideline Cuts Inappropriate Opioid Prescription

JANUARY 29, 2016
MD Magazine Staff
Temple University Researchers suggest that a guideline created by Temple University Hospital and Temple University Hospital-Episcopal Campus for prescribing opioids in order to maximize safety and avoid misuse appears to significantly decrease the rate of opioid prescribing for minor and chronic non-cancer pain complaints in an acute care setting.

Published in the January 2016 issue of the Journal of Emergency Medicine, the study found the impact to be immediate and sustained.

The results come in the midst of a prescription opioid abuse crisis in the United States where between 1999 and 2008 the rate of opioid overdose-associated deaths nearly quadrupled. The CDC has estimated that the rate of deaths related to prescription opioid overdoses now exceeds those from heroin and cocaine combined. 

With acute care settings recognized as a major source of inappropriate opioid prescriptions, emergency physicians—including those at Temple—have identified themselves at targets for patients seeking opioids for nonmedical reasons. However, clinicians must find a balance between offering pain relief to those patients who truly need it and not creating or exacerbating drug dependence. Thus, the US Department of Health and Human Services has recommended the synthesis of pain management guidelines and the creation of clinical decision support tools.

“The impact of this type of guideline had never been studied in an acute care setting,” said principal investigator Daniel del Portal, MD, FAAEM, Assistant Professor of Clinical Emergency Medicine at the Lewis Katz School of Medicine at Temple University and Assistant Director of Clinical Operations at Temple University Hospital and Jeanes Hospital. “We hypothesized that the rate at which opioids were prescribed in the emergency department for dental, neck/back and chronic pain would decrease after adoption of the guideline. We also hypothesized that physicians would support the use of the guideline.”

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