Physicians prescribe fewer opioids after county medical examiner notifies them of patients' fatal overdose

To overcome the disconnect between clinicians prescribing opioids and patients dying from opioid overdoses, researchers at Los Angeles-based University of Southern California aim to make the opioid epidemic more personal for physicians, according to a study published Aug. 10 in Science.

Researchers conducted a randomized trial between July 2015 and June 2016 of 861 clinicians in San Diego County who previously prescribed opioids to 170 patients who suffered a fatal overdose. Half of the clinicians received a letter from the county medical examiner, saying a patient they'd prescribed opioids to within the last 12 months had died. The letter also included information from the CDC on safe prescribing guidelines.

"Clinicians may never know a patient they prescribed opioids to suffered a fatal overdose. What we wanted to evaluate is whether closing that information gap will make them more judicious prescribers," Jason Doctor, PhD, director of Health Informatics at the USC Schaeffer Center for Health Policy & Economics and associate professor at the Price School of Public Policy at USC, told Science Daily.

Opioid prescribing decreased 9.7 percent after three months among physicians who received the letter, compared to the control group. Clinicians receiving the letter were 7 percent less likely to start a new patient on opioid treatment and were less likely to prescribe higher opioid doses.

"Interventions that use behavioral insights to nudge clinicians to correct course are powerful, low-cost tools because they maintain the autonomy of the physician to ultimately decide the best course of care for their patient," Dr. Doctor told Science Daily. "In this case, we know opioids, though beneficial to some patients with certain conditions, come with high risks that the [physician] may not fully grasp when observing patients in the clinic. Providing information about harm that would otherwise go unseen by them gives physicians a clearer picture."

More articles on opioids: 

Opioids after wisdom teeth surgery linked to risk of long-term use
Massachusetts sees spike in HIV cases among opioid users
FDA to change how it evaluates addiction drugs

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