Discrepancies in Written Versus Calculated Durations in Opioid Prescriptions: Pre-Post Study

Benjamin H Slovis; John Kairys; Bracken Babula; Melanie Girondo; Cara Martino; Lindsey M Roke; Jeffrey Riggio

doi:10.2196/16199

Discrepancies in Written Versus Calculated Durations in Opioid Prescriptions: Pre-Post Study

JMIR Med Inform. 2020 Mar 31;8(3):e16199. doi: 10.2196/16199.

Authors

Benjamin H Slovis^{1

2}, John Kairys^{1

3}, Bracken Babula^{1

4}, Melanie Girondo⁵, Cara Martino⁵, Lindsey M Roke⁵, Jeffrey Riggio^{1

4}

Affiliations

¹ Office of the Chief Medical Information Officer, Thomas Jefferson University, Philadelphia, PA, United States.
² Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA, United States.
³ Department of Surgery, Thomas Jefferson University, Philadelphia, PA, United States.
⁴ Department of Medicine, Thomas Jefferson University, Philadelphia, PA, United States.
⁵ Information Services and Technology, Thomas Jefferson University, Philadelphia, PA, United States.

PMID: 32229472
PMCID: PMC7157495
DOI: 10.2196/16199

Abstract

Background: The United States is in the midst of an opioid epidemic. Long-term use of opioid medications is associated with an increased risk of dependence. The US Centers for Disease Control and Prevention makes specific recommendations regarding opioid prescribing, including that prescription quantities should not exceed the intended duration of treatment.

Objective: The purpose of this study was to determine if opioid prescription quantities written at our institution exceed intended duration of treatment and whether enhancements to our electronic health record system improved any discrepancies.

Methods: We examined the opioid prescriptions written at our institution for a 22-month period. We examined the duration of treatment documented in the prescription itself and calculated a duration based on the quantity of tablets and doses per day. We determined whether requiring documentation of the prescription duration affected these outcomes.

Results: We reviewed 72,314 opioid prescriptions, of which 16.96% had a calculated duration that was greater than what was documented in the prescription. Making the duration a required field significantly reduced this discrepancy (17.95% vs 16.21%, P<.001) but did not eliminate it.

Conclusions: Health information technology vendors should develop tools that, by default, accurately represent prescription durations and/or modify doses and quantities dispensed based on provider-entered durations. This would potentially reduce unintended prolonged opioid use and reduce the potential for long-term dependence.

Keywords: duration; electronic health record; informatics; opioids; prescription.

©Benjamin H Slovis, John Kairys, Bracken Babula, Melanie Girondo, Cara Martino, Lindsey M Roke, Jeffrey Riggio. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 31.03.2020.