{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:43:24Z","timestamp":1787013804233,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T00:00:00Z","timestamp":1643760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["CE002520"],"award-info":[{"award-number":["CE002520"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Posttraumatic stress disorder (PTSD) is associated with higher rates of chronic pain and increased risk of developing Opioid use disorder. This paper evaluates the impact of PRIMUM, an electronic health record\u2010embedded (EHR) clinical decision support intervention on opioid prescribing patterns for patients with diagnosis of PTSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Inpatient, emergency department (ED), urgent care, and outpatient encounters with ICD\u201010 codes F43.1 (PTSD), F43.10 (PTSD, unspecified), F43.11 (PTSD, acute), and F43.12 (PTSD, chronic) at Atrium Health between 1\/1\/2016 and 12\/29\/2018 were included in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 3121 patients with a diagnosis of PTSD were seen in 37,443 encounters during the study period. Ten percent (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093761) of the encounters resulted in prescriptions for opioids and PRIMUM alerts were triggered in 1488 of these encounters. These alerts resulted in \u201cdecision influenced\u201d for 17% of patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009255) or no prescriptions for opioids or benzodiazepines for 5.8% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200986). The majority of the prescriptions were below 50 Morphine milligram equivalents (MME)\/day, but there were 570 (15.5%) prescriptions for doses of 50\u201390 MME and 721 (19.6%) prescriptions for &gt;90 MME\/day.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusion<\/jats:title>\n                    <jats:p>The PRIMUM alert system helps improve patient safety. PRIMUM affected clinician decisions 17% of the time, and the effect was greater in patients with opioid overdose history and those presenting for early refills.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Scientific Significance<\/jats:title>\n                    <jats:p>The effectiveness of clinical support interventions for opioid prescribing for patients with PTSD has not been documented previously. Our findings provide novel evidence that the EHR can be used to improve patient safety among patients with PTSD in the context of substance use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajad.13261","type":"journal-article","created":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T22:04:45Z","timestamp":1643839485000},"page":"123-131","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of an opioid prescribing alert system on patients with posttraumatic stress disorder"],"prefix":"10.1111","volume":"31","author":[{"given":"Durga","family":"Bestha","sequence":"first","affiliation":[{"name":"Department of Psychiatry Atrium Health Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shizuka","family":"Tomatsu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Atrium Health Charlotte North Carolina 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