The Effect of a Non-Opioid Order Set on Opioid Use in a Community Hospital Emergency Department

Abstract

Specific Aims: To describe trends in opioid ordering and prescribing within a community hospital emergency department (ED). To determine if a non-opioid order set influences opioid prescribing within the ED. Subjects: Providers who ordered opioids in the ED or prescribed opioid prescriptions upon discharge to adult patients. Methods: A retrospective analysis was conducted of the prescribing habits of ED providers before (April 1, 2019, to September 30, 2019) and after (April 1, 2020, to September 30, 2020) implementation of a non-opioid order set. Primary outcomes of interest were the number of opioid orders and the average opioid MME before and after the non-opioid order set implementation. Main Results: 35 providers were included in this study, with 71% (n=25) female and 29% (n=10) male. The group was composed of 22% physician assistants (n=8), 26% nurse practitioners (n=9), 46% doctors of medicine (n=16), and 6% doctors of osteopathic medicine (n=2). The studied providers accounted for 60% of all opioid orders administered within the ED. Opioid orders administered decreased from 8,608 in 2019 to 6,072 in 2020 (p=0.03). There were no significant changes to the average MME of opioid orders per patient seen in the ED. Conclusions: The analysis suggests that a non-opioid order set can decrease the number of opioids ordered in an ED. The data collected did not show significant changes in discharge prescriptions after implementation of the non- opioid order set.