CLEVELAND, Ohio – It's a well-documented fact that overdose from opioids has reached epidemic proportions, and Dr. Baruch Fertel, of the Cleveland Clinic, says, many times prescribing practices play a large role.
- A new study from the Cleveland Clinic shows how the emergency department used the electronic medical record system in order to reduce opioid prescribing
- The system allows the clinic to track the frequency and quantity of opioids doctors prescribe to patients
- Over the past year, Cleveland Clinic emergency departments have seen a 50 percent reduction in the total number of opioid prescriptions
“I don't think we realized at the time, the potential pitfalls and harms from controlling pain at all costs… no pain is dangerous and harmful as we see so many people are addicted,” said Fertel, director of quality and operations, emergency departments of Cleveland Clinic.
A new study from the Cleveland Clinic, just published in the American Journal of Emergency Medicine, shows how the emergency department used the electronic medical record in order to reduce inappropriate opioid prescribing.
“Seems so simple, but clinicians are going to take the path of least resistance,” said Fertel. “if the defaults that were set up years ago were for 30 Percocet tablets, then that's what people are going to prescribe. So, by simply erasing them and putting them in our guidelines we only recommend these medicines. We default 12, default three days’ supply.”
As a result of the interventions, the clinic's emergency rooms were able to cut the overall number of opioids prescribed in half over the past year.
“30 days people are used to doing 30 tablets. People don't want patients to come back with pain, and they tended on the side of over-treatment as opposed to under treatment,” said Fertel.
And the number of inappropriate prescriptions prescribed.
“Things like long-acting Oxycontin, it's not the role of an acute care setting, where someone has a short emergency, to be prescribing long-acting opioids or those kinds of medications,” said Fertel.
Fertel says this was done with self-reflection and correction of doctors across the clinic.
Your opioid prescribing rate is higher than your peers, any reason for it? And what it does is it prompts introspection and prompts people to pay more attention,” said Fertel.
Fertel says controlling pain at all cost has cost many lives, which is why patients understand and agree with the new prescribing practices.
“We were able to significantly reduce the amount of opioids we prescribed, and it has no impact on the satisfaction of our patients, the quality of care we're providing… in fact, where our patients are happy, we're communicating with them better. We're explaining things to them, and we're articulating why we're not doing it… it's harmful, we care about you. We don't want you to develop opioid tolerance or addiction,” said Fertel.
As a result of the study, multiple hospitals have incorporated changes, reducing preset prescription amounts.