Guidance for Providers to Reduce Opioid Overprescribing by 65%

Long-term opioid dependence often starts with treatment of patients’ acute pain, and studies have shown that dependence is more likely if a patient’s first-time prescription is given by a provider who frequently prescribes opioids. By helping providers change prescribing habits, Anne Arundel Medical Center has reduced opioid overprescribing by 65% since 2017.

As part of addressing opioid overprescribing, AAMC presented data collected from Epic regarding opioid ordering practices to physician prescribers and program leaders. This data was used to illustrate prescribing habits.

To help clinicians prescribe safe amounts of opioids, AAMC shows morphine milligram equivalents in Epic, so clinicians can understand how patients’ opioid doses add up during an admission or in the ambulatory setting. During prescribing, alerts let clinicians know which patients are at a higher risk for opioid dependence. They also removed long-acting opioids from order sets and adjusted them to default to an evidence-based standard prescribing level for many surgical procedures.

Patients with lower opioid prescriptions reported the same satisfaction with their care, demonstrating successful pain management without the need for riskier high doses of opioids.

“We are much safer now than we were three years ago,” said Dr. Barry Meisenberg, chair of Anne Arundel Medical Center’s department of medicine. “We still have work to do, but we’re practicing in a much safer way, have a better-educated public, and have increased accountability for use of these drugs.”

Epic community members can learn more about AAMC’s approach from their UGM slides on the UserWeb or in their study published in JAMA.