Evidence map›Paper›PMID 35216591›Full record

ArticleBMC medical informatics and decision making2022

Impact of CancelRx on discontinuation of controlled substance prescriptions: an interrupted time series analysis.

Taylor L Watterson, Jamie A Stone, Aaron Gilson, Roger Brown, Ka Z Xiong, Anthony Schiefelbein, Edmond Ramly, Peter Kleinschmidt, Michael Semanik, Lauren Craddock and 3 more

Open access · goldAbstract read
In one paragraph

Article in BMC medical informatics and decision making, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 1 country.

Taylor L WattersonUniversity of Wisconsin-Madison School of Pharmacy, 777 Highland Avenue, 2511 Rennebohm Hall, Madison, WI, 53704, USA.
Jamie A StoneUniversity of Wisconsin-Madison School of Pharmacy, 777 Highland Avenue, 2511 Rennebohm Hall, Madison, WI, 53704, USA.
Aaron GilsonUniversity of Wisconsin-Madison School of Pharmacy, 777 Highland Avenue, 2511 Rennebohm Hall, Madison, WI, 53704, USA.
Roger BrownUniversity of Wisconsin-Madison School of Nursing, Madison, WI, USA.
Ka Z XiongWisconsin Department of Health Services, Madison, WI, USA.
Anthony SchiefelbeinUniversity of Wisconsin-Madison School of Nursing, Madison, WI, USA.
Edmond RamlyUniversity of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Peter KleinschmidtUniversity of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Michael SemanikUniversity of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Lauren CraddockSSM Health Dean Medical Group, Madison, WI, USA.
Samantha I PittsJohns Hopkins Medicine, Baltimore, MD, USA.
Taylor WoodroofJohns Hopkins Medicine, Baltimore, MD, USA.
Michelle A ChuiUniversity of Wisconsin-Madison School of Pharmacy, 777 Highland Avenue, 2511 Rennebohm Hall, Madison, WI, 53704, USA. michelle.chui@wisc.edu.
University of Wisconsin–Madison · USJohns Hopkins University · USDean Health Systems · USMadison Area Technical College · USWisconsin Department of Health Services · US

Funding

University of Wisconsin Institute for Clinical and Translational ResearchUL1TR002373 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI ELIZABETH S BURNSIDE, Allan R. Brasier · 2017 to 2026
$75.9M
CancelRx: A Health IT tool to decrease medication discrepancies in the outpatient settingR21HS025793 · AHRQ · UNIVERSITY OF WISCONSIN-MADISON · PI CHUI, MICHELLE ANNE · 2018 to 2018
$286k
AHRQ HHS R21 HS025793NCATS NIH HHS UL1 TR002373
6 · The paper itself

Abstract

backgroundPrescription opioid misuse is a serious national crisis; in 2018 the top drugs involved in prescription overdose deaths included pain medications (opioids), benzodiazepines, and stimulants. Health information technology (health IT) provides a means to address this crisis through technologies that streamline the prescribing and discontinuation process. CancelRx is a health IT function that communicates when medications, such as controlled substances, are discontinued at the clinic and therefore should not be filled at the pharmacy. Prior to CancelRx, the communication of discontinued medications was a manual process, requiring the patient or a clinic staff member to personally contact the pharmacy to inform them of the change. The objective of this study was to assess how controlled substance medication discontinuations were communicated over time, before and after the implementation of CancelRx.

methodsSecondary data from a midwestern academic health system electronic health record and pharmacy platform were collected 12-months prior to CancelRx implementation and for 12-months post implementation. The study utilized an interrupted time series analysis (ITSA) to capture the percentage of controlled substance medications that were discontinued in the clinic's electronic health record and discontinued in the pharmacy's dispensing software. The ITSA plotted the percentage of successful discontinuation messages over time, particularly after the health system's implementation of CancelRx, a novel technology.

resultsAfter CancelRx implementation there was an immediate (change = 77.7 percentage point) and significant (p < 0.001) increase in the number of controlled substance medications that were successfully discontinued at the pharmacy after being discontinued in the clinic. This change was sustained in the year following CancelRx (slope = 0.03 pp, 95% CI - 0.050 to 0.110) and did not revert to pre-CancelRx levels. The health IT functionality was able to effectively complete discontinuation tasks and potentially reduce workload for clinic staff.

conclusionsOverall, this study demonstrates the role that technology can play in promoting communication between clinics and pharmacies, especially when medications such as controlled substances are discontinued.

Indexed as

Medical InformaticsPharmaciesControlled SubstancesHumansInterrupted Time Series AnalysisPrescriptionsControlled SubstancesControlled substancesHealth information technologyInterrupted time seriesOpioid epidemicPrescriptions

Identifiers

PMID35216591
PMCPMC8876377
OpenAlexW4214605631

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.