Evidence map›Paper›PMID 42367413›Full record

ArticleCureus2026

Reduction in Opioid Prescribing After Removal of Electronic Health Record Defaults Among Emergency Department Residents, Advanced Practice Providers, and Attendings.

Kito Lord, James R Walker, Michael Reich, Justin Griner, Chantay Smartt, Mark F Brady

Abstract read
In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

6 authors.

Kito LordEmergency Medicine, The University of Tennessee Health Science Center, Memphis, USA.
James R WalkerEmergency Medicine, The University of Tennessee Health Science Center, Memphis, USA.
Michael ReichEmergency Medicine, The University of Tennessee Health Science Center, Memphis, USA.
Justin GrinerPharmacy, Regional One Health, Memphis, USA.
Chantay SmarttEmergency Medicine, The University of Tennessee Health Science Center, Memphis, USA.
Mark F BradyEmergency Medicine, The Warren Alpert Medical School of Brown University, Providence, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction  Opioid prescription reduction is a high-priority quality improvement area in the emergency department (ED) with significant opportunities for harm reduction. While electronic health records (EHR) default dispense quantities have been used to help practitioners become more efficient, automated prescription quantities may influence prescribers to provide more than what they would otherwise deem necessary. We sought to evaluate the prescribing behavior of residents, advanced practice providers (APPs), and attending physicians after the removal of the default dispense quantity of the most prescribed opioid in the ED.  Methods  This is a single-center retrospective pre-post observational study in the ED of the four months before and the four months after removing the default dispense quantity of 20 tablets of oxycodone/acetaminophen per prescription. We compared the changes in prescribing patterns of emergency medicine (EM) attendings, EM APPs, EM residents, surgical attendings, surgical residents, and surgical APPs.  Results  During the study period, there were a total of 2,468 prescriptions for oxycodone/acetaminophen, resulting in 41,612 tablets prescribed. There were 1,314 prescriptions for oxycodone/acetaminophen before and 1,154 prescriptions written after the removal of the default dispense quantity. The average number of tablets per prescription was reduced from 18.16 to 15.35 after the removal of the default dispense quantity. There was no significant difference in the number of prescriptions written before and after the intervention in terms of patient age, gender, race, Emergency Severity Index (ESI) level, or department of the prescriber. An overall 15% reduction in the number of tablets of oxycodone/acetaminophen prescribed was observed. This reduction was significant among EM attendings, EM residents, EM APPs, and surgical attendings. There was no significant change among surgical residents and surgical APPs.  Conclusion  Removing the default dispense quantity was associated with a reduction in the amount of oxycodone/acetaminophen prescribed in most but not all categories of prescribers. While lower default quantities have reduced opioid prescription quantities, a default dispense quantity of 20 tablets may lead to overprescribing. As practice patterns and recommended guidelines change, default dispense quantities should periodically be evaluated for unintended influence on residents, APPs, and attendings' behavior.

Indexed as

electronic health recordopioidsoverprescribingprescribing behaviorquality improvement

Identifiers

PMID42367413
PMCPMC13309092

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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.