Emergency Department Providers Underestimate Own Opioid Prescribing Rates

Many emergency department (ED) physicians underestimate how often they prescribe opioids to patients, according to a year-long study published in Academic Emergency Medicine. However, alerting providers to their inaccurate perceptions with actual data could potentially alter future prescribing, according to the study authors.

Researchers at the University of Colorado Anschutz Medical Campus and the University of Massachusetts Medical School surveyed 109 emergency medicine providers at 4 different hospital EDs and asked them to report their perceived opioid prescribing rates compared with their peers. The researchers found that participants discharged 119,248 patients and wrote 75,203 prescriptions, of which approximately 20% were for opioids over the course of the study.

Although most physicians felt their prescribing habits were restrained, the actual results showed that some 65% of those surveyed prescribed more opioids than they thought. After showing the physicians their actual prescription rates, the researchers continued to monitor their opioid prescribing and found that overall prescribing rates decreased, especially in respondents who had been inaccurate in their self-perception. These physicians had 2.1 fewer opioid prescriptions per 100 patients after 6 months and 2.2% fewer prescriptions per 100 patients at 12 months.

The results indicate that correcting health providers’ self-perceptions using actual data can provoke more robust change when it comes to prescribing habits. According to the researchers, using data-driven interventions to show providers the reality of their actions versus their self-perceptions can be more effective in driving behavior change.

“Despite making progress on the opioid epidemic, we can’t assume providers are behaving optimally and have all the information they need to do what we are asking of them,” Sean Michael, MD, MBA, study author, said in a press release. “Most believe they are doing the right thing, but we need to directly address this thinking to be sure they are not part of the problem.”

The authors concluded that guideline and policy interventions should directly address the potential barrier of inaccurate provider self-awareness.

Reference

Michael SS, Babu KM, Androski C, et al. Effect of a data-driven intervention on opioid prescribing intensity among emergency department providers: a randomized controlled trial. Academic Emergency Medicine. 2018. https://doi.org/10.1111/acem.13400