How the presentation of patient information and decision-support advisories influences opioid prescribing behavior: A simulation study

Abstract Objective The United States faces an opioid crisis. Integrating prescription drug monitoring programs into electronic health records offers promise to improve opioid prescribing practices. This study aimed to evaluate 2 different user interface designs for prescription drug monitoring progr...

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Bibliographic Details
Published in:Journal of the American Medical Informatics Association : JAMIA 2020-04, Vol.27 (4), p.613-620
Main Authors: Hussain, Mustafa I, Nelson, Ariana M, Yeung, Brent G, Sukumar, Lauren, Zheng, Kai
Format: Article
Language:English
Subjects:
Analgesics, Opioid - therapeutic use
Brief Communication
Decision Support Systems, Clinical
Drug Prescriptions - statistics & numerical data
Electronic Health Records
Humans
Internship and Residency
Medical Order Entry Systems
Pain Management
Practice Patterns, Physicians
Prescription Drug Monitoring Programs
Systems Integration
United States
User-Computer Interface
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Summary:Abstract Objective The United States faces an opioid crisis. Integrating prescription drug monitoring programs into electronic health records offers promise to improve opioid prescribing practices. This study aimed to evaluate 2 different user interface designs for prescription drug monitoring program and electronic health record integration. Materials and Methods Twenty-four resident physicians participated in a randomized controlled experiment using 4 simulated patient cases. In the conventional condition, prescription opioid histories were presented in tabular format, and computerized clinical decision support (CDS) was provided via interruptive modal dialogs (ie, pop-ups). The alternative condition featured a graphical opioid history, a cue to visit that history, and noninterruptive CDS. Two attending pain specialists judged prescription appropriateness. Results Participants in the alternative condition wrote more appropriate prescriptions. When asked after the experiment, most participants stated that they preferred the alternative design to the conventional design. Conclusions How patient information and CDS are presented appears to have a significant influence on opioid prescribing behavior.
ISSN:1527-974X
1067-5027
1527-974X
DOI:10.1093/jamia/ocz213