1. Electronic health record intervention to increase use of NSAIDs as analgesia for hospitalised patients: a cluster randomised controlled study.
- Author
-
Robinson, Andrew, Lancaster, Elizabeth, Wick, Elizabeth, Auerbach, Andrew, Pletcher, Mark, Bongiovanni, Tasce, Behrends, Matthias, and Zhang, Li
- Subjects
Electronic Health Records ,Health Services Research ,Pain Management ,Adult ,Humans ,Anti-Inflammatory Agents ,Non-Steroidal ,Pain Management ,Analgesics ,Opioid ,Electronic Health Records ,Hospital Mortality ,Pain ,Analgesia - Abstract
BACKGROUND: Prescribing non-opioid pain medications, such as non-steroidal anti-inflammatory (NSAIDs) medications, has been shown to reduce pain and decrease opioid use, but it is unclear how to effectively encourage multimodal pain medication prescribing for hospitalised patients. Therefore, the aim of this study is to evaluate the effect of prechecking non-opioid pain medication orders on clinician prescribing of NSAIDs among hospitalised adults. METHODS: This was a cluster randomised controlled trial of adult (≥18 years) hospitalised patients admitted to three hospital sites under one quaternary hospital system in the USA from 2 March 2022 to 3 March 2023. A multimodal pain order panel was embedded in the admission order set, with NSAIDs prechecked in the intervention group. The intervention group could uncheck the NSAID order. The control group had access to the same NSAID order. The primary outcome was an increase in NSAID ordering. Secondary outcomes include NSAID administration, inpatient pain scores and opioid use and prescribing and relevant clinical harms including acute kidney injury, new gastrointestinal bleed and in-hospital death. RESULTS: Overall, 1049 clinicians were randomised. The study included 6239 patients for a total of 9595 encounters. Both NSAID ordering (36 vs 43%, p
- Published
- 2023