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Discrepancies in Written Versus Calculated Durations in Opioid Prescriptions: Pre-Post Study

机译：在阿片类药物处方的书写与计算持续时间的差异：毕业前的研究

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Background The United States is in the midst of an opioid epidemic. Long-term use of opioid medications is associated with an increased risk of dependence. The US Centers for Disease Control and Prevention makes specific recommendations regarding opioid prescribing, including that prescription quantities should not exceed the intended duration of treatment. Objective The purpose of this study was to determine if opioid prescription quantities written at our institution exceed intended duration of treatment and whether enhancements to our electronic health record system improved any discrepancies. Methods We examined the opioid prescriptions written at our institution for a 22-month period. We examined the duration of treatment documented in the prescription itself and calculated a duration based on the quantity of tablets and doses per day. We determined whether requiring documentation of the prescription duration affected these outcomes. Results We reviewed 72,314 opioid prescriptions, of which 16.96% had a calculated duration that was greater than what was documented in the prescription. Making the duration a required field significantly reduced this discrepancy (17.95% vs 16.21%, P .001) but did not eliminate it. Conclusions Health information technology vendors should develop tools that, by default, accurately represent prescription durations and/or modify doses and quantities dispensed based on provider-entered durations. This would potentially reduce unintended prolonged opioid use and reduce the potential for long-term dependence.
机译：背景美国在阿片类疫情中。长期使用阿片类药物与增加的依赖性有关。美国疾病控制和预防中心对阿片类药物进行了特定的建议，包括处方数量不应超过预期治疗持续时间。目的本研究的目的是确定在我们的机构编写的阿片类药物是否超过了持续的待遇持续时间，以及我们的电子健康记录系统是否改善了任何差异。方法检验在我们机构编写的阿片类药处，为22个月。我们检查了处方本身中记录的治疗时间，并根据片剂的量和每天剂量计算持续时间。我们确定需要对处方持续时间的文件影响这些结果。结果我们审查了72,314个阿片类药物处方，其中16.96％的计算持续时间大于处方于处方文件的持续时间。使得持续时间需要明显降低这种差异（17.95％与16.21％，P <.001），但没有消除它。结论健康信息技术供应商应开发工具，默认情况下，默认情况下，准确地代表处方持续时间和/或根据提供商输入的持续时间分配的剂量和数量。这可能会减少意外延长的阿片类药物使用，并减少长期依赖的可能性。

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