Opioid Prescribing After Implementation of Single Click Access to a State Prescription Drug Monitoring Program Database in a Health System's Electronic Health Record.
Opioid Prescribing After Implementation of Single Click Access to a State Prescription Drug Monitoring Program Database in a Health System's Electronic Health Record.
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在卫生系统的电子健康记录中实施单击访问州处方药监测计划数据库后的阿片类药物处方。
DOI：
10.1093/pm/pnab051
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Young,LeonardD
中科院分区：
文献类型：
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作者：
Weiner,ScottG;Kobayashi,Kimiyoshi;Reynolds,Joshua;Chan,Kit;Kelly,Rodd;Wakeman,Sarah;Reddy,Prabashni;Young,LeonardD
目的探讨一键整合国家处方药监测项目（PDMP）对PDMP搜索次数和阿片类药物处方的影响，并按专科分层。方法某大型卫生系统与国家公共卫生部门合作，将PDMP与电子健康记录（EHR）集成，使提供者能够在电子健康记录环境中一键查询数据。我们评估了在整合前6个月（2017年11月15日至2018年5月15日）和整合后6个月（2018年5月16日至2018年11月16日）向马萨诸塞州PDMP报告的附表II或III阿片类药物处方。搜索计数，处方，患者，吗啡毫克当量，以及处方医师专业进行比较。结果在两个研究期间，有3185名具有附表II和/或III阿片类药物处方记录的独特处方者符合纳入标准。整合后，PDMP的搜索量从整合前的208,684次增加到整合后的298,478次（+43.0%）。发放的阿片类药物处方数量减少4.8%，接受处方的患者数量减少5.1%，每位处方者的平均吗啡毫克当量（MMEs）减少5.4%。在这些测量中有一些显著的特殊差异。PDMP与EHR的整合显著增加了搜索次数，但与阿片类药物处方和接受处方的患者的适度减少有关。如果广泛实施PDMP的一次点击式EHR集成，可能是各州显著提高PDMP利用率的一种方式。
ObjectivesTo determine the effect of one-click integration of a state’s prescription drug monitoring program (PDMP) on the number of PDMP searches and opioid prescriptions, stratified by specialty.MethodsOur large health system worked with the state department of public health to integrate the PDMP with the electronic health record (EHR), which enabled providers to query the data with a single click inside the EHR environment. We evaluated Schedule II or III opioid prescriptions reported to the Massachusetts PDMP 6 months before (November 15, 2017-May 15, 2018) and 6 months after (May 16, 2018, to November 16, 2018) integration. Search counts, prescriptions, patients, morphine milligram equivalents, as well as prescriber specialty were compared.ResultsThere were 3,185 unique prescribers with a record of a Schedule II and/or III opioid prescription in both study periods that met inclusion criteria. After integration, the number of PDMP searches increased from 208,684 in the pre-integration phase to 298,478 searches in the post-integration phase (+43.0%). The number of opioid prescriptions dispensed decreased by 4.8%, the number of patients receiving a prescription decreased by 5.1%, and the mean morphine milligram equivalents (MMEs) per prescriber decreased by 5.4%. There were some notable specialty-specific differences in these measures.ConclusionsIntegration of the PDMP into the EHR markedly increased the number of searches but was associated with modest decreases in opioids prescribed and patients receiving a prescription. Single click EHR integration of the PDMP, if implemented broadly, may be a way for states to significantly increase PDMP utilization.