Lower default was associated with lower number of pills prescribed in eight of 15 pairwise comparisons
MONDAY, Feb. 3, 2020 (HealthDay News) — Altering the default settings in the electronic medical record can influence the quantity of opioids prescribed in an emergency department setting, according to a study published online Jan. 21 in JAMA Internal Medicine.
Juan Carlos C. Montoy, M.D., Ph.D., from the University of California in San Francisco, and colleagues examined whether and to what extent changes in the default settings in the electronic medical record are associated with opioid prescriptions for patients discharged from the emergency department. The prepopulated dispense quantities of discharge prescriptions for commonly prescribed opioids were randomly altered from status quo quantities of 12 and 20 tablets to null, five, 10, and 15 tablets at two large urban emergency departments.
During the study period, 104 health care professionals wrote 4,320 prescriptions for opioids. The researchers found that for each tablet increase in default quantity, there was an increase of 0.19 tablets prescribed. When they assessed each of 15 pairwise comparisons of default quantities, in more than half of the comparisons (eight of 15), a lower default was associated with a lower number of pills prescribed; a higher quantity was seen in one pairwise comparison, and no difference was seen in six comparisons.
“Our findings demonstrate a promising method to improve prescription practices while maintaining prescriber autonomy,” the authors write.
One author disclosed being a paid expert witness for Par Pharmaceutical in a medicolegal case.
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