Evidence map›Paper›PMID 36718091›Full record

Observational studyJournal of the American Medical Informatics Association : JAMIA2023

The effectiveness of a noninterruptive alert to increase prescription of take-home naloxone in emergency departments.

Lindsey K Jennings, Ralph Ward, Ekaterina Pekar, Elizabeth Szwast, Luke Sox, Joseph Hying, Jenna Mccauley, Jihad S Obeid, Leslie A Lenert

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in Journal of the American Medical Informatics Association : JAMIA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 13% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. The role of information systems in emergency department decision-making-a literature review.Journal of the American Medical Informatics Association : JAMIA · 2024
    Pooled it
  2. Article
  3. Article
  4. Article
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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

9 authors at 1 institution in 1 country.

Lindsey K JenningsDepartment of Emergency Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Ralph WardDepartment of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
Ekaterina PekarBiomedical Informatics Center, Medical University of South Carolina, Charleston, South Carolina, USA.ORCID 0000-0002-3491-6215
Elizabeth SzwastBiomedical Informatics Center, Medical University of South Carolina, Charleston, South Carolina, USA.
Luke SoxBiomedical Informatics Center, Medical University of South Carolina, Charleston, South Carolina, USA.
Joseph HyingBiomedical Informatics Center, Medical University of South Carolina, Charleston, South Carolina, USA.
Jenna MccauleyDepartment of Psychiatry and Behavioral Science, Addiction Sciences Division, Medical University of South Carolina, Charleston, South Carolina, USA.
Jihad S ObeidBiomedical Informatics Center, Medical University of South Carolina, Charleston, South Carolina, USA.ORCID 0000-0002-7193-7779
Leslie A LenertBiomedical Informatics Center, Medical University of South Carolina, Charleston, South Carolina, USA.
Medical University of South Carolina · US

Funding

Enhancing Infrastructure for Clinical and Translational Research to Address the Opioid EpidemicU01TR002628 · NCATS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI LENERT, LESLIE A. · 2019 to 2023
$3.7M
NCATS NIH HHS U01 TR002628
6 · The paper itself

Abstract

objectiveOpioid-related overdose (OD) deaths continue to increase. Take-home naloxone (THN), after treatment for an OD in an emergency department (ED), is a recommended but under-utilized practice. To promote THN prescription, we developed a noninterruptive decision support intervention that combined a detailed OD documentation template with a reminder to use the template that is automatically inserted into a provider's note by decision rules. We studied the impact of the combined intervention on THN prescribing in a longitudinal observational study.

methodsED encounters involving an OD were reviewed before and after implementation of the reminder embedded in the physicians' note to use an advanced OD documentation template for changes in: (1) use of the template and (2) prescription of THN. Chi square tests and interrupted time series analyses were used to assess the impact. Usability and satisfaction were measured using the System Usability Scale (SUS) and the Net Promoter Score.

resultsIn 736 OD cases defined by International Classification of Disease version 10 diagnosis codes (247 prereminder and 489 postreminder), the documentation template was used in 0.0% and 21.3%, respectively (P < .0001). The sensitivity and specificity of the reminder for OD cases were 95.9% and 99.8%, respectively. Use of the documentation template led to twice the rate of prescribing of THN (25.7% vs 50.0%, P < .001). Of 19 providers responding to the survey, 74% of SUS responses were in the good-to-excellent range and 53% of providers were Net Promoters.

conclusionsA noninterruptive decision support intervention was associated with higher THN prescribing in a pre-post study across a multiinstitution health system.

Indexed as

Drug OverdoseOpioid-Related DisordersEmergency Service, HospitalHumansNaloxoneNarcotic AntagonistsNaloxoneNarcotic Antagonistsdecision supportelectronic health recordemergency departmentnoninterruptiveopioid overdosetake-home naloxone

Identifiers

PMID36718091
PMCPMC10018256
OpenAlexW4318613943

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.