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The development of tools and resources to guide the busy practitioner in prescription decision-making is a welcome trend in healthcare, particularly when the information is instantly available from valuable sources, including Prescription Drug Monitoring Programs and the patient’s medication history. As outlined recently by Ms. Caldwell on the MEDHOST blog, marrying these resources into the prescription functionality of an EHR is a key component in the effort to combat the opioid crisis.
The U.S. healthcare community is just now starting to accept and address the fact that opioids are vastly overprescribed in this country. In 2012, there were 259 million opioid prescriptions – enough for nearly every person in the country. As opioid prescribing increased, so did the incidence of opioid abuse, addiction and deaths from overdose. The overprescribing of opioids, while not the sole cause, is a key factor in the genesis and continuation of the U.S. opioid crisis.
As healthcare providers, we need evidence-based, factual, accurate and timely resources so we are informed in our prescribing. Evidence-based facts include research showing that opioids are not appropriate first-line medications for uncomplicated low back pain and headaches. Alternative treatments not only work better but avoid opioid exposure. Consider a recent study1 that used data from EHR prescribing to show that multifocal interventions (education, oversight, changes in standard opioid orders) reduced the number of opioids prescribed per encounter by 58% and the overall opioid prescription rate by 38% over a six-month period. This and other studies support our need for resources at the point of patient care – instantly available and seamlessly accessed during every patient encounter when opioids are considered.
There are, of course, many additional factors besides overprescribing that contribute to the opioid crisis in the U.S., which in 2018 has sadly not yet peaked. The prescription of opioids, however, is entirely within the control of those with prescribing authority – physicians, physician assistants, and nurse practitioners. We should welcome resources that employ technology to augment our daily decision-making and inform us of the risks, benefits and alternatives to opioid prescribing. Now that most U.S. practitioners use EHRs, there is potential for every prescriber, patient and community to benefit from incorporating opioid prescribing resources into all EHR systems.
