The aims of this study were to evaluate the effects on
opioid medication prescribing, patient
opioid safety education, and prescribing of
naloxone following implementation of a Safer
Opioid Prescribing Protocol (SOPP) as part of the electronic health record (EHR) system at a Level I trauma center. This was a prospective observational study of the EHR of
trauma patients pre- (n = 191) and post-(n = 316) SOPP implementation between 2014 and 2016. At a comparison Level I
trauma site not implementing SOPP, EHRs for the same time period were assessed for any historical trends in
opioid and
naloxone prescribing. After SOPP implementation, the implementation site increased the use of nonnarcotic
pain medication, decreased dispensing high
opioid dose (≥100
MME [milligram
morphine equivalent]), significantly increased the delivery of
opioid safety education to patients, and initiated prescribing
naloxone. These changes were not found in the comparison site.
Opioid prescribing for
acute pain can be effectively reduced in a busy
trauma setting with a guideline intervention incorporated into an EHR. Guidelines can increase the use of nonnarcotic medications for the treatment of
acute pain and increase
naloxone coprescription for patients with a higher risk of overdose.