Medical examiner letters have impact on doctors’ opioid prescribing

opioid oxycodone Shutterstock 329x210 Medical examiner letters have impact on doctors opioid prescribingWould doctors who receive letters from a medical examiner informing them that a patient they treated died from a prescription drug overdose be less likely to prescribe opioids in the future? A group of researchers led by Jason Doctor of the University of South California’s Leonard D. Schaeffer Center for Health Policy and Economics, set out to tackle this question in a study recently published in the journal Science.

The letter, dated Jan. 27, 2017, was sent to 388 doctors, all of whom had prescribed at least one of several drugs with known risks to a patient within a year of the patient’s overdose death. The letters did not suggest the doctors were responsible for that patient’s death. Most of the 82 decedents named had received prescriptions from several sources, researchers noted.

The “courtesy communication” informed doctors “that your patient [name, date of birth inserted here] died on [date inserted here]. Prescription drug overdose was the primary cause of death or contributed to the death.” The letter, signed by the San Diego County medical examiner, went on to offer five prescribing tips to help lower overdose death rates.

For the study, researchers also found an additional 447 doctors who prescribed the same types of drugs to 85 patients who had died of overdose. They did not receive letters. Researchers looked at the prescribing practices of physicians in both groups over the next three months to determine whether the letter had made a difference. It had.

Doctors who received the letter reduced their prescribing of opioid medications by nearly 10 percent over the three-month study period, and prescribed opioids to 7 percent fewer patients, compared to doctors who did not receive the letter. The doctors who got the letter were also 3 to 4.5 percent less likely to write prescriptions for the highest doses of opioid drugs, which were the ones most often to blame for fatal overdoses.

Opioids kill 174 people each day in the United States. Reducing the prescribing of these powerful painkillers is another step to fighting the opioid epidemic that is devastating the country.

Source: LA Times