Electronic prescribing policy may decrease opioid prescriptions after hand surgery
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Published results showed an association between implementation of a state-mandated electronic prescribing policy and a decrease in the number of opioids prescribed after a variety of common hand procedures.
“Further studies are needed to establish the impact of [electronic prescribing] e-prescribing in various states and practice settings in order to assess the impact of cultural differences across regions in the United States,” Monica M. Shoji, MD, told Healio. “This data would provide the foundation to support the utility of e-prescribing in states that are yet to adopt it and facilitate the establishment of standardized postoperative protocols for opioid prescriptions.”
Shoji, Tamara D. Rozental, MD, and colleagues analyzed the number opioid tablets and morphine milligram equivalents prescribed to patients undergoing carpal tunnel release, ganglion excision, distal radius fracture open reduction and internal fixation, and carpometacarpal arthroplasty prior to (n=216) and after (n=212) implementation of a state-mandated e-prescribing policy. Researchers also analyzed factors associated with an increased total number of opioid tablets and morphine milligram equivalents.
Results showed a significant decrease in morphine milligram equivalents prescribed for ganglion excision and carpometacarpal arthroplasty after policy implementation. Researchers also found a significant decrease in the total number of tablets prescribed for ganglion excision, carpometacarpal arthroplasty and distal radius fracture open reduction and internal fixation. Researchers noted a significant decrease in the number of patients receiving any opioid prescriptions after carpal tunnel release and ganglion excision.
Across the entire patient sample, 18.5% of patients did not receive a single opioid prescription and 91% of patients did not request or require an opioid refill, according to results. Researchers noted the number of patients not receiving opioid prescriptions after surgery significantly increased following the implementation of the e-prescribing policy, from 10% before policy implementation to 27% after policy implementation. Results showed the number of patients who did not request or require an opioid refill did not change after policy implementation.
Multivariable linear regression analysis showed an association between age and implementation of an e-prescribing policy, with a decrease in the postoperative morphine milligram equivalents prescribed. Researchers also found an association between age and implementation of an e-prescribing policy, with a decrease in the number of tablets prescribed after surgery. The only patient factor associated with an increased number of opioid tablets prescribed after surgery was the presence of a chronic pain diagnosis, according to results.
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