Impact of order entry alerts and modifications on intermittent doses of intravenous opioid dispenses during a drug shortage Laura Bowers; Alex Raymond; Caity Guest; Jim Beardsley Wake Forest University Baptist Medical Center - PGY1 - Winston-Salem, NC
Background/Purpose: Drug shortages are an ongoing challenge for health systems and can significantly compromise patient care. Computer-based alerts have been utilized to influence provider prescribing behaviors; however, evidence for the efficacy and sustainability of this approach for the management of drug shortages is scarce. To address the intravenous opioid shortage, Wake Forest Baptist Medical Center implemented computer-based alerts at the time of order entry for intermittent doses of intravenous morphine, fentanyl and hydromorphone. This was conducted over two phases, which began in August 2017 and February 2018. The first phase notified providers of the implemented restricted use criteria and redirected providers to alternative oral products. The second phase further tightened restrictions and set the default order frequency to _x001C_once as needed_x001D_. The ordering provider was also required to indicate the attending physician who approved the order, the location of care, and the approved indication.
Methodology: A retrospective, single-center study was conducted to evaluate the efficacy and sustainability of the interventions described above. Dispense data was collected from automatic dispensing cabinets (ADCs) from September 2016 to March 2017 (baseline), September 2017 to January 2018 (phase 1), and February 2018 to March 2018 (phase 2). Data from procedural areas was excluded. The primary outcome was the number of intermittent doses of intravenous opioid dispenses during each study period. Secondary outcomes included the number of oral and intravenous opioid dispenses by week, unit type (floor, emergency department, intensive care unit, oncology, and pediatrics), and approved indication.
Presentation Objective: Describe the impact of order entry alerts and modifications on intravenous opioid dispenses during a drug shortage.
Self-Assessment: Did order entry alerts and modifications influence provider prescribing behaviors?
