EMR-based Approach to Opioids Offers Peace of Mind to Prescribers

June 25, 2014
Adam Hochron

Internal Medicine World Report, June 2014,

Although many primary care physicians remain uncertain of how to best help patients in pain manage their opioid prescriptions, new research shows a standardized protocol based on electronic medical records can get patients the assistance they need while providing peace of mind to prescribers.

Although many primary care physicians (PCPs) remain uncertain of how to best help patients in pain manage their opioid prescriptions, new research shows a standardized protocol based on electronic medical records (EMRs) can get patients the assistance they need while providing peace of mind to prescribers.

In a study published in the Journal of Family Practice, Robin E. Canada, MD, and her research team concluded prescription information transmitted electronically from PCPs to chronic non-cancer pain (CNCP) patients establishes a better experience for all parties involved.

For their study, Canada and her colleagues provided participating PCPs with a concise system of information technology and developed an EMR-based protocol with an objective to “evaluate provider adherence to this protocol, attitudes toward the management of these patients, and knowledge of opioid prescribing.”

While working with PCPs and select staff from 3 primary care practices in the Division of General Internal Medicine at the University of Pennsylvania, the researchers helped the doctors streamline their processes for prescribing opioids for CNCP. To measure the practices’ success, the investigators examined how the PCPs diagnosed a CNCP patient, whether a urine drug screen (UDS) was ordered for the patient within the past year, and whether the patient visited the PCP every 6 months. The PCPs and their staff were also surveyed on their knowledge and attitudes toward opioid prescribing, as well as offered a monetary incentive to adhere to the study protocols.

At the end of the study, Canada and her team reported an increase in UDS orders by as much as 145%, while chronic pain diagnoses increased by 424%. The authors also recorded improvements in role adequacy, role support, and job satisfaction among PCPs in regards to prescribing opioids to patients. Additionally, 89% of the primary care teams received the monetary incentive by adhering to the study protocols.

“We developed a quality improvement intervention that addressed the need for better regulation of opioid prescribing, resulted in increased adherence to best-practice guidelines, and improved provider knowledge and attitudes,” the authors concluded.

While the yearlong study produced positive results, Canada and her co-authors said there is more work to be done within the greater medical community, as they noted opioids are second only to marijuana in regards to illicit drug use in the United States, and there have been more overdose deaths related to opioid use than heroin and cocaine combined. Part of that work includes further education of PCPs and their medical staff, though the researchers also encouraged doctors to follow national guidelines for prescribing opioids.