Effect of an Opioid Prescribing Protocol on Provider Prescribing Behavior

Objectives: Opioid abuse continues to cause harm on epidemic proportions. Dental providers are leading prescribers, specifically to individuals under 18 years of age. To address this issue the University of Minnesota department of oral and maxillofacial surgery implemented an opioid prescribing protocol for the treatment of post-surgical pain. This retorspective analysis evaluates the use of opioid analgesics at the University of Minnesota School of Dentistry, prior to and following implementation of the opioid prescribing protocol.
Methods: This retrospective analysis compares the number of total opioid prescriptions and number of tablets per prescription in the previous 10 quarters prescribed by the University of Minnesota School of Dentistry. Prescription data was collected from institutional electronic health record software. All prescriptions for FDA schedule opioids written within the of the University of Minnesota School of Dentistry were collected. Data was collected under the specifications of IRB 1701M04361. Statistical analysis was completed with aid from department of biostatistics.
Results: The University of Minnesota School of Dentistry wrote 5279 opioid prescriptions across all departments in the five quarters prior to the introduction of the opioid protocol on October 1st, 2016. The five quarters following the introduction of the Opioid Prescribing Protocol in February 2016, 2792 opioid prescriptions were written resulting in a 47.1% overall decrease in number of opioid prescriptions written. There has been a linear decrease in number of opioid prescriptions written since the introduction of the protocol in first quarter of 2016. There was also a decrease in the number of tablets prescribed per opioid prescription. The pre-protocol prescriptions averaged 15.7 tablets and the post-protocol prescriptions averaged 12.9 tablets, a decrease of 17.9%.
Conclusions: Our results support the hypothesis that an opioid prescribing protocol would be successful in decreasing the total number of opioid prescriptions written and number of tablets dispensed per prescription while appropriately addressing postoperative pain