ArticleAmerican journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists2024
Impact of automated alerts on discharge opioid overprescribing after general surgery.
Article in American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Dot Phrase Utilization and Opioid Prescription at Discharge for Subarachnoid Hemorrhage Patients.The Neurohospitalist · 2026Article
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Authors and funding
7 authors.
Funding
Abstract
purposeThe objectives of this study were to identify the most performed surgical procedures associated with the highest rates of discharge opioid overprescribing and to implement an electronic health record (EHR) alert to reduce discharge opioid overprescribing.
methodsThis quality improvement, before-and-after study included patients undergoing one of the identified target procedures-laparoscopic cholecystectomy, unilateral open inguinal hernia repair, and laparoscopic appendectomy-at an academic medical center. The alert notified providers when the prescribed opioid quantity exceeded guideline recommendations. The preimplementation cohort included surgical encounters from January 2020 to December 2021. The EHR alert was implemented in May 2022 following provider education via email and in-person presentations. The postimplementation cohort included surgical encounters from May to August 2022. The primary outcome was the proportion of patients with a discharge opioid supply exceeding guideline recommendations (overprescribing).
resultsA total of 1,478 patients were included in the preimplementation cohort, and 141 patients were included in the postimplementation cohort. The proportion of patients with discharge opioid overprescribing decreased from 48% in the preimplementation cohort to 3% in the postimplementation cohort, with an unadjusted absolute reduction of 45% (95% confidence interval, 41% to 49%; P < 0.001) and an adjusted odds ratio of 0.03 (95% confidence interval, 0.01 to 0.08; P < 0.001). Among patients who received opioids, the mean (SD) opioid supply at discharge decreased from 92 (43) oral morphine milligram equivalents (MME) (before implementation) to 57 (20) MME (after implementation) (P < 0.001). The proportion of patients who received additional opioid prescriptions within 1 to 14 days following hospital discharge did not change (P = 0.76).
conclusionImplementation of an EHR alert along with provider education can reduce discharge opioid overprescribing following general surgery.
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