Evaluation of emergency department opioid prescribing and implementation of an opioid-light multi-modal approach to analgesia Lacey Boutwell, Daniel Marsh, Rachel Kile, Patrick Ellis Memorial Health Care System - Chattanooga, TN
Background/Purpose: The widespread use and abuse of opioids has become an epidemic of regional and global proportions. Worldwide, an estimated 15 million people suffer from opioid dependence and about 69,000 die from an opioid overdose each year. The emergency department (ED) is the largest source for opioid analgesics for ambulatory outpatients, with 39% of all opioids prescribed, administered or continued in the emergency room. Other institutions have implemented a multi-modal opioid-light approach to analgesia for specific conditions, where opioids are used as second line therapy or as rescue medications. This resulted in greater analgesia, reduced doses of medications given, fewer side effects and shorter length of hospital stay for admitted patients. Our project seeks to evaluate the trend in ED opioid prescribing and implement a multi-modal approach to analgesia.
Methodology: This retrospective chart review includes patients triaged into Simple Triage and Rapid Treatment (START) in the ED at the Glenwood campus at Memorial Hospital in Chattanooga, Tennessee. Adults who received an opioid during September 2017 were included in this assessment. Patients were excluded if they were subsequently admitted as an inpatient. The primary endpoint is the morphine equivalency given per 100 patients in the ED. Secondary endpoint is the percentage of opioid prescriptions written upon discharge for patients who also received an opioid in the ED.
Results: A total of 797 patients were screened and 141 patients were included for analysis. An average of 17.7% of patients who were seen in START received an opioid and of those patients 55% also left with a prescription for an opioid.
Presentation Objective: Identify the prevalence of opioid use in the ED and determine opioid-light alternatives for analgesia for specific indications.
Self-Assessment: What particular patient populations may not benefit, or may even be harmed, by using non-opioid alternatives in the ED?
