Opioid Prescription Patterns for Discharged Patients from the Emergency Department

Context. Opioid prescriptions from the emergency department (ED) have gradually increased over the last 20 years. Mounting evidence of the potential for abuse of these drugs, even after a transient ED encounter, has fueled a push to curtail the prescriptions of opioids from the ED. Objectives. It is...

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Main Authors: Justin Yanuck, Jonathan B. Lee, Soheil Saadat, Jila Rouhi, Ghadi Ghanem, Bharath Chakravarthy, Shalini Shah
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Pain Research and Management
Online Access:http://dx.doi.org/10.1155/2021/4980170
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author Justin Yanuck
Jonathan B. Lee
Soheil Saadat
Jila Rouhi
Ghadi Ghanem
Bharath Chakravarthy
Shalini Shah
author_facet Justin Yanuck
Jonathan B. Lee
Soheil Saadat
Jila Rouhi
Ghadi Ghanem
Bharath Chakravarthy
Shalini Shah
author_sort Justin Yanuck
collection DOAJ
description Context. Opioid prescriptions from the emergency department (ED) have gradually increased over the last 20 years. Mounting evidence of the potential for abuse of these drugs, even after a transient ED encounter, has fueled a push to curtail the prescriptions of opioids from the ED. Objectives. It is important to analyze the types of etiologies and provider demographics that drive opioid prescription in our emergency departments. Our study aimed to determine which patients in the ED are receiving opioid prescriptions, as well as their strength and quantity. Secondary outcomes included identifying difference in prescribing between provider classes. Methods. We conducted a retrospective study at a tertiary care university-based, level-one trauma ED from November 2017 to October 2018. We identified and analyzed data from 2,259 patients who were sent home with an opioid prescription. We retrieved patient and provider demographics, diagnosis, etiologies, and prescription information. Results. The mean age of a patient receiving an opioid prescription was 45, and 72.7% of patients were white. The most common diagnosis groups associated with an opioid prescription were abdominal pain (18.5%), nonfracture extremity pain (18.4%), and back/neck pain (12.5%). Hydrocodone-acetaminophen 5–325 mg was the most commonly prescribed (67.4%). The median total prescribed milligram morphine equivalent (MME) was highest for extremity fracture (75.0; IQR 54.0–100.0). The median total prescribed amount of pills was highest for patients with extremity fractures (15.0; IQR 12.0–20.0). Conclusions. Our study elucidates the prescribing patterns of an academic level 1 trauma center and should pave the way for future studies looking to maximize effectiveness at ways to curb ED opioid prescription.
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spelling doaj-art-4c98d0334eee42c69332c90376c278742025-02-03T00:58:50ZengWileyPain Research and Management1203-67651918-15232021-01-01202110.1155/2021/49801704980170Opioid Prescription Patterns for Discharged Patients from the Emergency DepartmentJustin Yanuck0Jonathan B. Lee1Soheil Saadat2Jila Rouhi3Ghadi Ghanem4Bharath Chakravarthy5Shalini Shah6Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston 02114, Massachusetts, USADepartment of Emergency Medicine, University of California, Irvine, California, USADepartment of Emergency Medicine, University of California, Irvine, California, USADepartment of Anesthesiology & Perioperative Care, University of California, Irvine, California, USADepartment of Emergency Medicine, University of California, Irvine, California, USADepartment of Emergency Medicine, University of California, Irvine, California, USADepartment of Anesthesiology & Perioperative Care, University of California, Irvine, California, USAContext. Opioid prescriptions from the emergency department (ED) have gradually increased over the last 20 years. Mounting evidence of the potential for abuse of these drugs, even after a transient ED encounter, has fueled a push to curtail the prescriptions of opioids from the ED. Objectives. It is important to analyze the types of etiologies and provider demographics that drive opioid prescription in our emergency departments. Our study aimed to determine which patients in the ED are receiving opioid prescriptions, as well as their strength and quantity. Secondary outcomes included identifying difference in prescribing between provider classes. Methods. We conducted a retrospective study at a tertiary care university-based, level-one trauma ED from November 2017 to October 2018. We identified and analyzed data from 2,259 patients who were sent home with an opioid prescription. We retrieved patient and provider demographics, diagnosis, etiologies, and prescription information. Results. The mean age of a patient receiving an opioid prescription was 45, and 72.7% of patients were white. The most common diagnosis groups associated with an opioid prescription were abdominal pain (18.5%), nonfracture extremity pain (18.4%), and back/neck pain (12.5%). Hydrocodone-acetaminophen 5–325 mg was the most commonly prescribed (67.4%). The median total prescribed milligram morphine equivalent (MME) was highest for extremity fracture (75.0; IQR 54.0–100.0). The median total prescribed amount of pills was highest for patients with extremity fractures (15.0; IQR 12.0–20.0). Conclusions. Our study elucidates the prescribing patterns of an academic level 1 trauma center and should pave the way for future studies looking to maximize effectiveness at ways to curb ED opioid prescription.http://dx.doi.org/10.1155/2021/4980170
spellingShingle Justin Yanuck
Jonathan B. Lee
Soheil Saadat
Jila Rouhi
Ghadi Ghanem
Bharath Chakravarthy
Shalini Shah
Opioid Prescription Patterns for Discharged Patients from the Emergency Department
Pain Research and Management
title Opioid Prescription Patterns for Discharged Patients from the Emergency Department
title_full Opioid Prescription Patterns for Discharged Patients from the Emergency Department
title_fullStr Opioid Prescription Patterns for Discharged Patients from the Emergency Department
title_full_unstemmed Opioid Prescription Patterns for Discharged Patients from the Emergency Department
title_short Opioid Prescription Patterns for Discharged Patients from the Emergency Department
title_sort opioid prescription patterns for discharged patients from the emergency department
url http://dx.doi.org/10.1155/2021/4980170
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