Opioid Prescribing in the Emergency Department: Provider Knowledge, Attitude and Practice Related to the New Jersey State Statute

Abstract

In response to the national opioid crisis, many states have implemented opioid prescribing statutes in the past year. Research regarding the impact of these statutes on the opioid prescribing practices of providers in an ED setting is limited. Published findings reveal varying patterns of opioid prescribing among ED practitioners and indicate decreases in opioid prescribing when prescribing guidelines are implemented. Currently, no studies delineate a causal relationship. This research describes the effects of an educational intervention related to the 2017 New Jersey state-mandated statue on opioid prescribing practices of providers in a community hospital emergency department (ED). The purpose of the intervention is to provide education on the most current state statutes on opioid prescribing while informing ED providers on appropriate management of acute pain in order to adhere to state regulations, thereby engage in safe opioid prescribing practices.

The research design was quasi-experimental, comprising a pre-post and follow-up assessment of an educational intervention, focusing on self-reported provider knowledge, attitudes and practice (KAP) related to opioid prescribing practices. The pre-post and follow-up data collection instruments were based on both evidence (e.g., related to knowledge of opioid addiction and the new state law) and the research questions. A targeted sample of fourteen providers who currently prescribe opioids in a community hospital ED participated in the intervention and completed the surveys. The intervention included a self-directed 10-15 minute educational PowerPoint reflecting the most current evidence based practice (EBP). The PowerPoint was developed using the most current New Jersey State Statute on opioid prescribing, guidelines from the American Academy of Emergency Medicine (AAEM) and recommendations from the Ernest Mario Rutgers School of Pharmacy.

Descriptive analysis was used for the quantitative data. Thematic analysis was used for qualitative data, identifying categories based on responses to the open-ended questions, and themes across the questions.

All participants acknowledged that there was an opioid addiction problem in NJ. The majority (86%) had received communication about the statute prior to this intervention. The majority (57%) reported the key requirements of the NJ opioid prescribing statute. On follow-up (7 or 70 %) participants reported both seeking continuing education and implementing opioid guidelines. 64% reported that the statute influenced their prescribing patterns and 90% agreed that the educational intervention influenced their opioid prescribing practice.

As the opioid epidemic continues to escalate, education on the most current prescribing laws and evidence-based practice is a vital component of policies to address this urgent public health problem. ED providers report that the state statute regulation, and education related to it and to EBPs influence their prescribing opioids, helping to ensure adherence to the regulations and contributing to reduction of opioid addiction.