Informing physicians of patients' fatal overdoses reduces prescriptions up to 1 year - Healio

Clinicians who were notified aft 1 of their patients fatally overdosed prescribed less opioids for up to 1 twelvemonth compared with those who were not notified, according to results of a randomized objective trial.

“Clinicians don’t needfully cognize a diligent they prescribed opioids to has suffered a fatal overdose,” Jason N. Doctor, PhD, seat of the section of wellness argumentation and absorption astatine the University of Southern California’s Sol Price School of Public Policy and co-director of the behavioral sciences programme astatine USC’s Schaeffer Center for Health Policy & Economics, said successful a property release. “We knew closing this accusation loop instantly reduced opioid prescriptions. Our latest survey shows that change successful prescribing behaviour seems to stick.”

Clinicians who were notified aft 1 of their patients fatally overdosed prescribed less opioids for up to 1 twelvemonth compared with those who were not notified, according to results of a randomized objective trial. Source: Adobe Stock

Previously, successful 2018, Doctor and colleagues conducted a randomized objective proceedings to find whether letters from a region aesculapian examiner that notified clinicians of their patients’ overdoses would trim opioid prescribing. The letter, which was meant to beryllium some respectful and informative, provided accusation astir harmless opioid prescribing, according to Doctor and colleagues. The researchers recovered a astir 10% alteration successful prescriptions for morphine milligram equivalents (MME) up to 3 months aft clinicians received the letter. They additionally recovered that the fig of patients taking high-dose opioids decreased successful the panels of clinicians who received the letter.

For the existent study, the researchers analyzed whether these trends would proceed up to 1 year.

The last illustration included 809 clinicians — astir of whom were aesculapian doctors — and 166 decedents successful San Diego County, California. Rather than the combined effects of intoxicant oregon an illicit drug, Doctor and colleagues reported that the superior origin of decease was attributed to an opioid prescription, accounting for 94 deaths (56.29%).

In the 4 to 12 months aft receiving letters, 223,399 opioid prescriptions were dispensed. During this time, the fig of full play MMEs dispensed decreased 7.1% (95% CI, 0.37-13.79) much successful the missive involution radical than successful the power group. Additionally, caller patients taking opioids decreased by 2.02 percent points (95% CI, 0.79-3.25) much successful the involution radical than successful the control.

The researchers noted nary important differences betwixt the effects astatine 1 to 3 oregon 4 to 12 months for full MME alteration oregon caller patients. There were besides nary differences successful the fig of prescriptions that were astatine slightest 50 MME astatine 4 to 12 months.

“The caller survey shows this alteration is not conscionable a impermanent blip and past clinicians went backmost to their erstwhile prescribing,” Doctor said successful the release. “This low-cost involution has a long-lasting impact.”

This could beryllium due to the fact that of clinicians’ consciousness of being observed and an injunction from authority, the researchers wrote.

They besides noted that the survey did not “address the alarming acceleration of fatal overdoses by illicit fentanyl.”

“The bittersweet information is, we ne'er addressed the archetypal occupation of deaths from prescribed opioids. In fact, it’s each mixed unneurotic due to the fact that nationally, astir fractional of radical who dice of an illicit fentanyl cause overdose person besides had an opioid medicine wrong the past year,” Doctor said successful the release.

The main takeaway, according to Doctor, is that the letters from aesculapian examiners connection an accidental to get successful interaction with providers aft overdose deaths to prevention lives.

“The missive is simply a nudge to providers that the opioid epidemic is successful their assemblage and affecting their patients. It is casual to work the headlines and presume you are not portion of the problem,” Doctor said successful the release. “Doctors person an accidental to speech to their patients and see alternatives to opioids. I judge we tin scope astir fractional of the radical successful the illicit fentanyl epidemic done a doc who has seen them.”

In airy of the findings, Doctor and colleagues are present moving with Los Angeles County connected imaginable policies similar mandating messages from region aesculapian examiners to clinicians, according to the release.

References:

• Doctor JN, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2022.49877.
• Doctor JN et al. Science. 2018;doi:10.1126/science.aat4595.
• USC survey suggests 1 solution to America’s opioid epidemic: Tell doctors their patients fatally overdosed. https://www.eurekalert.org/news-releases/975825. Published Jan. 6, 2023. Accessed Jan. 11, 2023.