{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T21:57:57Z","timestamp":1766181477857,"version":"3.37.3"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,10,17]],"date-time":"2020-10-17T00:00:00Z","timestamp":1602892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Department of Quality Analytics"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Deaths have increased, and prescription medications are involved in a significant percentage of deaths. Emergency department (ED) changes to managing acute pain and prescription drug monitoring programs (PDMPs) can impact the potential for abuse.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed the impact of a series of quality improvement initiatives on the opioid prescribing habits of emergency department physicians and advanced practice providers. We compared historical prescribing patterns with those after three interventions: 1) the implementation of a PDMP, 2) clinician education on alternatives to opioids (ALTOs), and 3) electronic health record (EHR) process changes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There was a 61.8% decrease in the percentage of opioid-eligible ED discharges that received a prescription for an opioid from 19.4% during the baseline period to 7.4% during the final intervention period. Among these discharges, the cumulative effect of the interventions resulted in a 17.3% decrease in the amount of morphine milligram equivalents (MME) prescribed per discharge from a mean of 104.9 MME\/discharge during the baseline period to 86.8 MME\/discharge. In addition, the average amount of MME prescribed per discharge became aligned with recommended guidelines over the intervention periods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Initiating a PDMP and instituting an aggressive ALTO program along with EHR-modified process flows have cumulative benefits in decreasing MME prescribed in an acute ED setting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnaa278","type":"journal-article","created":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T19:13:28Z","timestamp":1598382808000},"page":"499-505","source":"Crossref","is-referenced-by-count":9,"title":["Alternatives to Opioid Education and a Prescription Drug Monitoring Program Cumulatively Decreased Outpatient Opioid Prescriptions"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1610-7094","authenticated-orcid":false,"given":"Adam","family":"Sigal","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Reading Hospital, West Reading, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankit","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Reading Hospital, West Reading, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Onderdonk","sequence":"additional","affiliation":[{"name":"Department of Quality Analytics and Improvement, Reading Hospital, West Reading, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Traci","family":"Deaner","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Reading Hospital, West Reading, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Schlappy","sequence":"additional","affiliation":[{"name":"Department of Quality Analytics and Improvement, Reading Hospital, West Reading, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Barbera","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Reading Hospital, West Reading, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,10,17]]},"reference":[{"key":"2021022320184533300_pnaa278-B1"},{"key":"2021022320184533300_pnaa278-B2"},{"key":"2021022320184533300_pnaa278-B3"},{"key":"2021022320184533300_pnaa278-B4"},{"issue":"5","key":"2021022320184533300_pnaa278-B5","doi-asserted-by":"crossref","first-page":"422","DOI":"10.5811\/westjem.2012.7.12936","article-title":"Prescription drug monitoring programs and other interventions to combat 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