Hands reaching for pills

Lowering prescription defaults for postoperative opioids in an Electronic Medical Record (EMR) system from 30 tablets to 12 reduced the amount of opioids prescribed by more than 15 percent across an entire health system, according to a new study.

Researchers conducted a pre-post intervention study in which they lowered the default number of opioids autopopulated in the EMR when prescribing discharge analgesia from 30 to 12, and then compared postprocedural prescribing patterns during the three months before and after the default change. After the default change, the median number of opioid tablets prescribed dropped from 30 to 20 per prescription.

The percentage of prescriptions written for 30 tablets decreased from 39.7 percent before the default change to 12.9 percent after the default change, and the percentage of prescriptions written for 12 tablets increased from 2.1 percent to 24.6 percent. Regression analysis demonstrated a decline of 5.22 opioid tablets per prescription after the default change, for a total decrease of 34.41 morphine milligram equivalents (MME) per prescription. The researchers concluded that reducing the default number of opioids prescribed in an EMR system is a simple and effective way to change prescriber behavior and affect postoperative opioid prescribing.

Read more about default drug counts in EMR systems here.

“Partners within the Great Plains QIN have had success with similar interventions.  Decreasing the default number of tablets in EMR orders is consistent with the CDC Guidelines for Prescribing Opioids for Chronic Pain.  It not only changes prescriber behavior as stated in the story, but it also reduces the number of unused prescription opioids in the community that could be diverted, stated Jayme Steig, Pharm D, RPh, Great Plains QIN Quality Improvement Program Manager.

The Great Plains QIN partners with providers, pharmacists and stakeholders in the region to reduce and monitor Adverse Drug Events (ADEs). A specific strategy to advance this work is to monitor Medicare consumer ADE rates on several prescription medications; one being opioids. Learn how you can partner with the Great Plains QIN to reduce ADEs by visiting our website.