Skip to main content

  • Alert Systems May Curb Opioid Dosing

    By Lynda Seminara
    Selected by Richard K. Parrish II, MD
    Add to My Bookmarks

    Journal Highlights

    American Journal of Ophthalmology, November 2022

    Download PDF

    Opioid alert systems have led to a decline in opioid prescriptions in some specialties, but data pertaining to ophthalmology are sparse. Blaga et al. looked at opioid prescribing trends in ophthalmology and explored the effect of an alert system on prescribing patterns. They found that demograph­ics played a role in the prescribing of opioids and that an alert system could reduce the volume of opioid prescrip­tions in the eye care setting.

    The study was retrospective in de­sign and compared prescribing trends before and after implementation of an electronic opioid alert system. Study participants were adults who received prescriptions for opioid medication from an ophthalmologist within a tertiary care center during a period of approximately seven years. The mean morphine-equivalent daily dose (MEDD) per prescription was com­pared before and after instituting the alert system, whereby any prescription that exceeded a mean MEDD of 30 or a seven-day supply for an adult would prompt the system to signal an alert. In this study, the system applied only to prescriptions issued electronically at discharge to manage acute pain. Paper scripts were not included.

    The study population included 8,014 patients and 9,055 separate prescriptions for an opioid. More than three-fourths of the prescriptions were for pain management following an ophthalmic surgery. After the alert system was implemented, the mean MEDD per prescription decreased by 15.17 (p < .001), from 40.05 to 24.88, indicating the system’s effec­tiveness. The per-prescription MEDD was higher for male patients (33.53 vs. 32.55 for females; p < .001) and for Black individuals (33.93 vs. 32.80 for Whites; p = .03). Patients with a disorder of the eyelid, orbit, or lacri­mal system had the highest proportion of opioid prescriptions (57.4% of the total), followed by patients with a disorder of the sclera, cornea, iris, or ciliary body (16%).

    A unique aspect of this study is its emphasis on morphine equivalents specific to ophthalmology, said the authors. The authors recommend com­paring these observed trends and dos­ages with those of other institutions, which may lay the groundwork for developing national opioid prescribing guidelines for ophthalmologists.

    The original article can be found here.