Article Text
PDF
Abstract
Background and Aims Despite increased attention to optimizing prescribing practices in response to the opioid epidemic in the United States, limited guidance is available to assist the prescriber and patient with weaning off these medications. Numerous barriers to effective tapering exist.1–4 In order to address these barriers and leverage the advantages of electronic health record (EHR) systems, our team sought to develop a novel electronic tool (e-tool) to facilitate the selection of and compliance with an opioid tapering schedule.
Methods As a clinical informatics and e-tool development project, Institutional Review Board review was not required. An assessment of current functionalities for medication tapering in Epic, our hospital’s EHR, was performed to identify components for optimization. Clinical members of a specialized opioid task force selected tapering options to include in the novel tool build, and customized graphical instructions to match these prescriber’s options were created.
Results A fully integrated, novel electronic opioid tapering tool was built in our hospital’s EHR system. Upon entering an opioid in the novel order entry workflow, the prescriber can select from pre-programmed tapering plans that consider starting dose, frequency of medication use, the frequency of dosage decrease and the desired opioid reduction (Figure 1). The output is a personalized, tapering schedule with graphical instructions that can be printed or emailed to the patient and stored in the patient‘s electronic medical record for future reference (Figure 2).
Conclusions Barriers to opioid tapering can be overcome by leveraging EHR functionality to create, automate, and generate personalized plans and instructions with images.