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Analysis

Opioid Prescriptions Drop Nearly 10% When Docs Told of Patients' OD Deaths

By John Commins  
   August 10, 2018

Researchers say behavioral 'nudges' could play a critical role in reducing the opioid epidemic.  

Physicians are apt to reduce the number and dosage of opioids they prescribe after learning that a patient had died from an overdose, according to a study funded by the National Institute on Aging.

Researchers found that physicians in the San Diego area who were told of a patient's overdose death reduced the number of opioids prescribed by 9.7% in the following three months.

"This finding could be very useful in the effort to reduce inappropriate prescribing of opioids without severely restricting availability of legally prescribed opioids for patients who should be getting them," NIA Director Richard J. Hodes, MD, said in comments accompanying the study.

"It shows that physicians respond to information about adverse outcomes. Behavioral 'nudges' like these letters could be a tool to help curb the opioid epidemic," he said.

Over 12-months straddling 2015 and 2016, the county reported 222 deaths involving Schedule II, III or IV drugs as the primary or contributing cause. Of these, 170 deaths were listed in the Controlled Substance Utilization Review and Evaluation System database.

The 861 prescribing clinicians reviewed by the researchers were divided into an intervention (388) and a control (438) group. The intervention group received a letter from the county medical examiner. The control group did not.

The letter identified the patient by name, address and age, and outlined the annual number and types of prescription drug deaths seen by the medical examiner. It also showed how to access California's prescription drug monitoring program and reviewed safe prescribing strategies.

The researchers said the notifications may not work for larger populations, but could work on the county level.

John Haaga, director of NIA's Division of Behavioral and Social Research, said the findings " illustrates one small and relatively inexpensive method of reducing the number of opioid prescriptions written, thus reducing the number of drugs available for misuse."

John Commins is a senior editor at HealthLeaders.


KEY TAKEAWAYS

Opioid prescriptions drop 9.7% when physicians are told that a patient has died from an overdose.

Researchers suggest that 'behavioral nudges' can raise physician awareness and reduce opioid use.


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