Article, April/19: Assn EHR Alerts and Co-prescribing of Opioids and Benzos

[[se...]]

Journal: Journal of General Internal Medicine

 

Full title: "The Association of EHR Drug Safety Alerts and Co-prescribing of Opioids and Benzodiazepines"

 

Abstract:

BACKGROUND

Concurrent opioid and benzodiazepine use is associated with an increased risk of overdose, compared with opioid users who do not use benzodiazepines.1,2 Reflecting this safety concern, the Center for Disease Control and Prevention’s 2016 chronic pain guideline recommended against co-prescribing opioids and benzodiazepines.3 Nevertheless, clinicians frequently co-prescribe these medications. A recent estimate finds that 17% of opioid users concurrently use a benzodiazepine.1

 

OBJECTIVE

To determine the percentage of visits resulting in an opioid prescription for a patient with an active benzodiazepine prescription, and vice versa, before and after the implementation of an electronic health record (EHR) alert notifying clinicians at the time of prescribing of the dangers of concurrent opioid and benzodiazepine use.

 

METHODS AND FINDINGS

We conducted a retrospective analysis using EHR data from all office and outpatient clinic visits occurring between April 2017 and April 2018 at...

 

https://link.springer.com/article/10.1007%2Fs11606-019-04985-w

 

 

From the full text version:

"On October 11, 2017, Fairview initiated an EHR alert designed to deter concurrent prescribing of opioids and benzodiazepines in office settings."

...

"We observed no significant change in the level of benzodiazepine prescribing immediately following the intervention (p = 0.56), and the adjusted trend in benzodiazepine prescribing decreased after the intervention (p = 0.02). There was no statistically significant change in the level of opioid prescribing (p = 0.24) or in the trend in opioid prescribing after the intervention (p = 0.80)."

 

[[ch...]]

THIS enrages me.... i could've been killed by an Urgent Care 'Doc' who forced these 2 drugs on me.

 

i was literally force-fed my 1st benzo in Urgent care + a shot of Tramdol -- both AGAINST MY WILL. 

 

i begged for the med i'd listed at triage -- Baclofen -- which a stupid GP had CT'd me off + told me to take Magnesium instead.

 

suffered horrific WD -- full body seized up, unable to move a muscle -- or go to bed, lasting 12+ hrs... until 2am when i took a double dose out of desperation.

 

then my own GP allowed me to re-instate it so i could try to 'taper'.

 

next day -- waited hours in Urgent Care -- last patient to be seen -- for a suspected UTI that may have spread to my kidneys.

 

so i missed my Baclofen dose + by 11 pm full body seized up in chair + again couldn't move a muscle or move my head.

 

kept begging the Doc for my Rx'd med -- but he just kept saying "I can't help you".

 

he didn't explain why he refused to give me my Rx'd med.

 

nor did he explain what he was forcing into my mouth - a benzo.

 

nor did he explain what he was shooting into my arm - an opioid.

 

they just wanted rid of me so they could close up, since not a 24hr ER.

 

all they needed to do was give me my measly 5mg of nasty Baclofen.

 

i passed out so long into the next day my spouse almost called 911 thinking i might die -- but he managed to shake me awake.

 

...this is how i ended up disabled + stuck on 2 benzos now, almost 3 yrs later.

 

i never complained as i didn't know any better at the time... but if only i was able to find the discharge docs now -- i might try + report that negligent 'Doc'.

 

i'm guessing i'm not the only person to be 'mis-prescribed' this deadly combo....but you'd think an 'Urgent Care Doc' would know better...

 

 

....sorry for the rant     ....thanks for posting for our safety + awareness + that's why i wanted to share my horror story.

 

.... but if we're forced this deadly combo against our will.... IDK....

 

[[cs...]]

Journal: Journal of General Internal Medicine

 

Full title: "The Association of EHR Drug Safety Alerts and Co-prescribing of Opioids and Benzodiazepines"

 

Abstract:

BACKGROUND

Concurrent opioid and benzodiazepine use is associated with an increased risk of overdose, compared with opioid users who do not use benzodiazepines.1,2 Reflecting this safety concern, the Center for Disease Control and Prevention’s 2016 chronic pain guideline recommended against co-prescribing opioids and benzodiazepines.3 Nevertheless, clinicians frequently co-prescribe these medications. A recent estimate finds that 17% of opioid users concurrently use a benzodiazepine.1

 

OBJECTIVE

To determine the percentage of visits resulting in an opioid prescription for a patient with an active benzodiazepine prescription, and vice versa, before and after the implementation of an electronic health record (EHR) alert notifying clinicians at the time of prescribing of the dangers of concurrent opioid and benzodiazepine use.

 

METHODS AND FINDINGS

We conducted a retrospective analysis using EHR data from all office and outpatient clinic visits occurring between April 2017 and April 2018 at...

 

https://link.springer.com/article/10.1007%2Fs11606-019-04985-w

 

 

From the full text version:

"On October 11, 2017, Fairview initiated an EHR alert designed to deter concurrent prescribing of opioids and benzodiazepines in office settings."

...

"We observed no significant change in the level of benzodiazepine prescribing immediately following the intervention (p = 0.56), and the adjusted trend in benzodiazepine prescribing decreased after the intervention (p = 0.02). There was no statistically significant change in the level of opioid prescribing (p = 0.24) or in the trend in opioid prescribing after the intervention (p = 0.80)."

 

Thanks for posting this very important topic.