Abstract
Background
Drug overdose was the leading cause of injury and death in 2013, with drug misuse
and abuse causing approximately 2.5 million emergency department (ED) visits in 2011.
The Electronic Prescriptions for Controlled Substances (EPCS) program was created
with the goal of decreasing rates of prescription opioid addiction, abuse, diversion,
and death by making it more difficult to “doctor-shop” and alter prescriptions.
Objective
In this study, we describe the opioid-prescribing patterns of emergency physicians
after the introduction of the New York State EPCS mandate.
Methods
We conducted a retrospective, single-center, descriptive study with a pre-/post-test
design. The pre-implementation period used for comparison was April 1–July 31, 2015
and the post-implementation period was April 1–July 31, 2016. All ED discharge prescriptions
for opioid medications prior to and after the initiation of New York State EPCS were
identified.
Results
During the pre-implementation study period, 22,221 patient visits were identified
with 1366 patients receiving an opioid prescription. During the post-implementation
study period, 22,405 patient visits were identified with 642 patients receiving an
opioid prescription. This represented an absolute decrease of 724 (53%) opioid prescriptions
(p < 0.0001), which is an absolute difference of 2.3% (95% confidence interval 2.0–2.6%).
Conclusions
There was a significant decline in the overall number of opioid prescriptions after
implementation of the New York EPCS mandate.
Keywords
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References
- Opioid prescription drug use and expenditures in US outpatient physician offices: evidence from two nationally representative surveys.Cancer Ther Oncol Int J. 2017; 3: 555611
- Opioid pain medication prescriptions obtained through emergency medical visits in the Veterans Health Administration.J Opioid Manage. 2017; 13: 77-84
- Dramatic Rise in Emergency Department Opioid Scripts. Medscape.(Available at:)
- A survey of physicians' perspectives on the New York State mandatory prescription monitoring program (ISTOP).J Subst Abuse Treat. 2016; 70: 35-43
- Controlled substances add new layer to e-prescribing.Consult Pharm. 2016; 31: 200-206
- Interim Final Rule with Request for Comment Questions and Answers for Prescribing Practitioners.(Available at:)https://www.deadiversion.usdoj.gov/ecomm/e_rx/fq/practitioners.htmDate: 2010Date accessed: November 1, 2017
- The effect of a statewide mandatory prescription drug monitoring program on opioid prescribing by emergency medicine providers across 15 hospitals in a single health system.J Pain. 2018; 19: 430-438
- States push to combat opioid abuse with e-prescribing technology.(Available at:)https://surescripts.com/news-center/intelligence-in-action/opioids/states-push-to-combat-opioid-abuse-with-e-prescribing-technology/Date: 2017Date accessed: November 1, 2017
- Opioid analgesic prescription rate per 1,000 population.(Available at:)
- Surescripts’ Interoperable Network Connects 1.3 Million Healthcare Professionals to Deliver Nearly 11 Billion Secure Transactions in 2016.(Available at:)
- Impact of prescription drug-monitoring program on controlled substance prescribing in the ED.Am J Emerg Med. 2015; 33: 781-785
- Evaluation of Florida physicians' knowledge and attitudes toward accessing the state prescription drug monitoring program as a prescribing tool.Pain Med. 2014; 15: 2013-2019
- Clinical policy: critical issues in the prescribing of opioids for adult patients in the emergency department.Ann Emerg Med. 2012; 60: 499-525
Article info
Publication history
Published online: June 27, 2019
Accepted:
March 30,
2019
Received in revised form:
March 17,
2019
Received:
June 12,
2018
Footnotes
The study was approved by the Staten Island University Hospital Institutional Review Board.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
