Longitudinal impact of a pre‐populated default quantity on emergency department opioid prescriptions

Abstract Objective Previously published studies indicate that a pre‐populated default quantity may decrease opioid amounts on discharge prescriptions from the emergency department (ED). However, the longitudinal effect of defaulted quantities has not been described in the literature. Methods A retro...

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Main Authors: Alexandra Carlson, Michael E. Nelson, Hina Patel
Format: Article
Language:English
Published: Elsevier 2021-02-01
Series:Journal of the American College of Emergency Physicians Open
Subjects:
Online Access:https://doi.org/10.1002/emp2.12337
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author Alexandra Carlson
Michael E. Nelson
Hina Patel
author_facet Alexandra Carlson
Michael E. Nelson
Hina Patel
author_sort Alexandra Carlson
collection DOAJ
description Abstract Objective Previously published studies indicate that a pre‐populated default quantity may decrease opioid amounts on discharge prescriptions from the emergency department (ED). However, the longitudinal effect of defaulted quantities has not been described in the literature. Methods A retrospective review of electronic health record data from visits to 4 hospital EDs in a community health system examined opioid prescription dispense quantities 3.5 years pre‐ and 6.5 years post‐implementation of a defaulted dispense quantity of seventeen. The primary purpose was to determine the percentage of ED discharge opioid prescriptions containing the prepopulated default dispense quantity after implementation. The longitudinal effect of a default quantity implementation on the average quantity prescribed (normalized per 1000 visits) was examined by comparing the pre‐implementation period (January 1, 2009–July 31, 2012) to the post‐implementation period (August 1, 2012–June 30, 2018). Results After implementation in 2012, the acceptance rate of the default dispense quantity increased each year, up to 48% in 2016 and maintained through 2018. A significant decrease in prescribed opioid quantities post‐default quantity implementation was sustained, with the average quantity prescribed from 2015–2018 maintained at 17 or lower. Conclusion A pre‐populated default quantity impacts discharge opioid prescribing as evidenced by a high sustained rate of prescriber utilization over years and reduction in the per prescription average pill quantity. The acceptance of a pre‐populated default quantity may allow for selection of even a lower quantity to influence prescribing patterns of opioid analgesics.
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spelling doaj-art-33dbde7612cd4cf1aea047ef6bc58b9a2025-08-20T02:15:41ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522021-02-0121n/an/a10.1002/emp2.12337Longitudinal impact of a pre‐populated default quantity on emergency department opioid prescriptionsAlexandra Carlson0Michael E. Nelson1Hina Patel2NorthShore University Health System Evanston IL USANorthShore University Health System Evanston IL USANorthShore University Health System Evanston IL USAAbstract Objective Previously published studies indicate that a pre‐populated default quantity may decrease opioid amounts on discharge prescriptions from the emergency department (ED). However, the longitudinal effect of defaulted quantities has not been described in the literature. Methods A retrospective review of electronic health record data from visits to 4 hospital EDs in a community health system examined opioid prescription dispense quantities 3.5 years pre‐ and 6.5 years post‐implementation of a defaulted dispense quantity of seventeen. The primary purpose was to determine the percentage of ED discharge opioid prescriptions containing the prepopulated default dispense quantity after implementation. The longitudinal effect of a default quantity implementation on the average quantity prescribed (normalized per 1000 visits) was examined by comparing the pre‐implementation period (January 1, 2009–July 31, 2012) to the post‐implementation period (August 1, 2012–June 30, 2018). Results After implementation in 2012, the acceptance rate of the default dispense quantity increased each year, up to 48% in 2016 and maintained through 2018. A significant decrease in prescribed opioid quantities post‐default quantity implementation was sustained, with the average quantity prescribed from 2015–2018 maintained at 17 or lower. Conclusion A pre‐populated default quantity impacts discharge opioid prescribing as evidenced by a high sustained rate of prescriber utilization over years and reduction in the per prescription average pill quantity. The acceptance of a pre‐populated default quantity may allow for selection of even a lower quantity to influence prescribing patterns of opioid analgesics.https://doi.org/10.1002/emp2.12337default quantityemergency departmentlong‐term impactopioid prescribing
spellingShingle Alexandra Carlson
Michael E. Nelson
Hina Patel
Longitudinal impact of a pre‐populated default quantity on emergency department opioid prescriptions
Journal of the American College of Emergency Physicians Open
default quantity
emergency department
long‐term impact
opioid prescribing
title Longitudinal impact of a pre‐populated default quantity on emergency department opioid prescriptions
title_full Longitudinal impact of a pre‐populated default quantity on emergency department opioid prescriptions
title_fullStr Longitudinal impact of a pre‐populated default quantity on emergency department opioid prescriptions
title_full_unstemmed Longitudinal impact of a pre‐populated default quantity on emergency department opioid prescriptions
title_short Longitudinal impact of a pre‐populated default quantity on emergency department opioid prescriptions
title_sort longitudinal impact of a pre populated default quantity on emergency department opioid prescriptions
topic default quantity
emergency department
long‐term impact
opioid prescribing
url https://doi.org/10.1002/emp2.12337
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AT michaelenelson longitudinalimpactofaprepopulateddefaultquantityonemergencydepartmentopioidprescriptions
AT hinapatel longitudinalimpactofaprepopulateddefaultquantityonemergencydepartmentopioidprescriptions