{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:33:22Z","timestamp":1790195602098,"version":"4.1.0"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Provider prescribing practices contribute to an excess of opioid-related deaths in the United States. Clinical guidelines exist to assist providers with improving prescribing practices and promoting patient safety. Clinical decision support systems (CDSS) may promote adherence to these guidelines and improve prescribing practices. The aim of this project was to improve opioid guideline adherence, prescribing practices, and rates of opioid-related encounters through the implementation of an opioid CDSS.<\/jats:p><jats:p>\n          Methods\u2003A vendor-developed, provider-targeted CDSS package was implemented in a multi-location academic health center. An interrupted time-series analysis was performed, evaluating 30 weeks pre- and post-implementation time periods. Outcomes were derived from vendor-supplied key performance indicators and directly from the electronic health record (EHR) database. Opioid-prescribing outcomes included count of opioid prescriptions, morphine milligram equivalents per prescription, counts of opioids with concurrent benzodiazepines, and counts of short-acting opioids in opioid-na\u00efve patients. Encounter outcomes included rates of encounters for opioid abuse and dependence and rates of encounters for opioid poisoning and overdose. Guideline adherence outcomes included rates of provision of naloxone and documentation of opioid treatment agreements.<\/jats:p><jats:p>\n          Results\u2003The opioid CDSS generated an average of 1,637 alerts per week. Rates of provision of naloxone and opioid treatment agreements improved after CDSS implementation. Vendor-supplied prescribing outcomes were consistent with prescribing outcomes derived directly from the EHR, but all prescribing and encounter outcomes were unchanged.<\/jats:p><jats:p>\n          Conclusion\u2003A vendor-developed, provider-targeted opioid CDSS did not improve opioid-prescribing practices or rates of opioid-related encounters. The CDSS improved some measures of provider adherence to opioid-prescribing guidelines. Further work is needed to determine the optimal configuration of opioid CDSS so that opioid-prescribing patterns are appropriately modified and encounter outcomes are improved.<\/jats:p>","DOI":"10.1055\/s-0042-1745830","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T00:35:01Z","timestamp":1650501301000},"page":"419-430","source":"Crossref","is-referenced-by-count":11,"title":["Impact of a Vendor-Developed Opioid Clinical Decision Support Intervention on Adherence to Prescribing Guidelines, Opioid Prescribing, and Rates of Opioid-Related Encounters"],"prefix":"10.1055","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6281-0848","authenticated-orcid":false,"given":"Robert P.","family":"Pierce","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia, Missouri, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernie","family":"Eskridge","sequence":"additional","affiliation":[{"name":"Department of Child Health, University of Missouri School of Medicine, Columbia, Missouri, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandi","family":"Ross","sequence":"additional","affiliation":[{"name":"Tiger Institute, Cerner Corporation, Columbia, Missouri, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Wright","sequence":"additional","affiliation":[{"name":"University of Missouri Health Care, Columbia, Missouri, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Selva","sequence":"additional","affiliation":[{"name":"Department of Child Health, University of Missouri School of Medicine, Columbia, Missouri, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,4,20]]},"reference":[{"issue":"11","key":"ref3","doi-asserted-by":"crossref","first-page":"290","DOI":"10.15585\/mmwr.mm6911a4","article-title":"Drug and opioid-involved overdose deaths\u2014United States, 2017-2018","volume":"69","author":"N Wilson","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"13","key":"ref4","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1001\/jama.2011.370","article-title":"Association between opioid prescribing patterns and opioid overdose-related deaths","volume":"305","author":"A SB Bohnert","year":"2011","journal-title":"JAMA"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6501e1","article-title":"CDC guideline for prescribing opioids for chronic pain\u2014United States, 2016","volume":"65","author":"D Dowell","year":"2016","journal-title":"MMWR Recomm Rep"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"38","DOI":"10.7326\/0003-4819-160-1-201401070-00732","article-title":"Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain","volume":"160","author":"T K Nuckols","year":"2014","journal-title":"Ann Intern Med"},{"key":"ref7","volume-title":"Quality Improvement and Care Coordination: Implementing the CDC Guideline for Prescribing Opioids for Chronic Pain","author":"Centers for Disease Control and Prevention.","year":"2018"},{"issue":"09","key":"ref8","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1007\/s11606-011-1648-2","article-title":"Low use of opioid risk reduction strategies in primary care even for high risk patients with chronic pain","volume":"26","author":"J L Starrels","year":"2011","journal-title":"J Gen Intern Med"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1111\/papr.12289","article-title":"Are physicians safely prescribing opioids for chronic noncancer pain? 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