Dental pain management with prescription opioids by nondental healthcare professionals in a healthcare system network
| Autor: | Jillian M, Rigert, Joel J, Napenas, Meghan, Wally, Susan, Odum, Ziqing, Yu, Michael, Runyon, Joseph R, Hsu, Rachel B, Seymour, Stephen, Wyatt |
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| Rok vydání: | 2021 |
| Předmět: |
Pain
Drug Prescriptions Clinical decision support system 03 medical and health sciences 0302 clinical medicine Intervention (counseling) SAFER medicine Humans Pain Management Medical prescription Risk factor General Dentistry Practice Patterns Dentists' Point of care 030505 public health Descriptive statistics business.industry Public Health Environmental and Occupational Health 030206 dentistry medicine.disease Analgesics Opioid Opioid Medical emergency 0305 other medical science business medicine.drug |
| Zdroj: | Journal of Public Health Dentistry. 82:22-30 |
| ISSN: | 1752-7325 0022-4006 |
| Popis: | Objectives Patients with dental pain seek treatment in Urgent and Emergency Care settings by physicians and advanced practice practitioners (APPs) unable to provide definitive care, often relying on prescriptions for pain management including opioids. In the face of an opioid epidemic, this study assessed the impact of an electronic health record (EHR) clinical decision support tool to identify patients at high risk for opioid misuse using objective, evidence-based criteria, and guide safer prescribing. Methods Dental pain encounters occurring between January 2016 and June 2018 within our healthcare system were identified and linked to the database supporting a real-time clinical decision support intervention, Prescription Reporting with Immediate Medication Utilization Mapping (PRIMUM), to characterize opioid prescribing patterns and prescribers' response to alert. Descriptive analysis of the data was performed. Results There were 30,649 dental pain encounters of which opioids were written in 45.5 percent (N = 13,957) encounters. A total of 16.6 percent of patients prescribed an opioid had a risk factor for misuse and triggered the PRIMUM alert at the point of care. In response to the PRIMUM alert (N = 2,501 encounters), clinician decision-making was influenced in 9.5 percent (N = 237) of encounters, which was defined by cancelation of the original opioid prescription. Of those 9.5 percent encounters, 48.1 percent (N = 114) resulted in no opioid prescription written. Conclusions There is potential for a clinical decision support tool embedded in the EHR to guide safer prescribing practice by alerting providers to objective, evidence-based risk characteristics at the point of care. |
| Databáze: | OpenAIRE |
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