Physicians Underestimate Their Opioid Prescribing Habits

Findings from a new study have revealed that emergency department (ED) providers may underestimate their own opioid prescribing habits, indicating the potential benefit of guideline and policy interventions to address opioid overprescribing in this setting.

During the study, 109 participants (attending physicians, residents, and advanced practice providers) across 4 EDs were randomly assigned to a brief data-driven intervention or no intervention (control group).
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Participants who underwent the intervention self-identified and reported their perceived opioid prescribing habits compared with their peers. Subsequently, participants were provided with their actual prescribing data compared with peer group norms.

A total of 51 participants had undergone the intervention, and the remaining participants served as controls. Results showed that approximately 65% of intervention participants had underestimated their own opioid prescribing.

At 6- and 12-month follow-ups, intervention participants who underestimated their opioid prescribing at baseline had demonstrated larger-magnitude decreases in prescribing vs controls (Hodges‐Lehmann difference = -2.1 prescriptions per hundred patients at 6 months and -2.2 per hundred at 12 months).

The researchers noted that intervention participants who did not underestimate their opioid prescribing habits at baseline had demonstrated similar changes to controls.

“Self‐perception of prescribing was frequently inaccurate,” the researchers concluded. “Providing clinicians with their actual opioid prescribing data after querying their self‐perception reduced future prescribing among providers who underestimated their baseline prescribing.”

“Our findings suggest that guideline and policy interventions should directly address the potential barrier of inaccurate provider self‐awareness,” they added.

—Christina Vogt

Reference:

Michael SS, Babu KM, Androski C, Reznek MA. Effect of a data-driven intervention on opioid prescribing intensity among emergency department providers: a randomized controlled trial [Published online April 2, 2018]. Acad Emerg Med. https://doi.org/10.1111/acem.13400.