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Journal of General Internal Medicine

, Volume 34, Issue 8, pp 1403–1405 | Cite as

The Association of EHR Drug Safety Alerts and Co-prescribing of Opioids and Benzodiazepines

  • Laura Barrie Smith
  • Ezra Golberstein
  • Kelly Anderson
  • Tori Christiaansen
  • Nicole Paterson
  • Sonja Short
  • Hannah T. NeprashEmail author
Concise Research Reports

BACKGROUND

Concurrent opioid and benzodiazepine use is associated with an increased risk of overdose, compared with opioid users who do not use benzodiazepines.1,2 Reflecting this safety concern, the Center for Disease Control and Prevention’s 2016 chronic pain guideline recommended against co-prescribing opioids and benzodiazepines.3 Nevertheless, clinicians frequently co-prescribe these medications. A recent estimate finds that 17% of opioid users concurrently use a benzodiazepine.1

OBJECTIVE

To determine the percentage of visits resulting in an opioid prescription for a patient with an active benzodiazepine prescription, and vice versa, before and after the implementation of an electronic health record (EHR) alert notifying clinicians at the time of prescribing of the dangers of concurrent opioid and benzodiazepine use.

METHODS AND FINDINGS

We conducted a retrospective analysis using EHR data from all office and outpatient clinic visits occurring between April 2017 and April 2018 at...

Notes

Acknowledgements

This research was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences (Grant No. UL1TR002494) and the Agency for Healthcare Research and Quality T32 trainee program (Smith). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health’s National Center for Advancing Translational Sciences nor the Agency for Healthcare Research and Quality.

Compliance with Ethical Standards

The study was approved by the University of Minnesota IRB.

Conflict of Interest

Ms. Smith reports no conflict of interest.

Dr. Golberstein reports no conflict of interest.

Ms. Anderson reports no conflict of interest.

Dr. Christiaansen reports no conflict of interest.

Dr. Paterson reports no conflict of interest.

Dr. Short reports no conflict of interest.

Dr. Neprash reports receiving consulting compensation from athenahealth, Inc.

References

  1. 1.
    Sun EC, Dixit A, Humphreys K, Darnall BD, Baker LC, Mackey S. Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis. BMJ 2017;356:j760.CrossRefGoogle Scholar
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    Hernandez I, He M, Brooks MM, Zhang Y. Exposure-Response Association Between Concurrent Opioid and Benzodiazepine Use and Risk of Opioid-Related Overdose in Medicare Part D Beneficiaries. JAMA Netw Open 2018;1(2):e180919.CrossRefGoogle Scholar
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    Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016. JAMA 2016;315(15):1624.CrossRefGoogle Scholar
  4. 4.
    Genco EK, Forster JE, Flaten H, et al. Clinically Inconsequential Alerts: The Characteristics of Opioid Drug Alerts and Their Utility in Preventing Adverse Drug Events in the Emergency Department. Ann Emerg Med 2016;67(2):240–248.e3.CrossRefGoogle Scholar
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    Ballo J, Boczenowski MLSS, Mccready BSRG, et al. Pain Management Resources to Support Clinical Decision Support Artifact Development: An Environmental Scan. Agency for Healthcare Research and Quality; 2017.Google Scholar

Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Laura Barrie Smith
    • 1
  • Ezra Golberstein
    • 1
  • Kelly Anderson
    • 2
  • Tori Christiaansen
    • 2
  • Nicole Paterson
    • 2
  • Sonja Short
    • 2
  • Hannah T. Neprash
    • 1
    Email author
  1. 1.Division of Health Policy & Management, School of Public Health University of MinnesotaMinneapolisUSA
  2. 2.Fairview Health ServicesMinneapolisUSA

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