A new study finds that sending a letter to doctors notifying doctors of a patient's overdose death and assisting with future planning is an effective intervention.Physicians who receive notification that a patient died of an overdose are more cautious in prescribing controlled substances if the notification includes a plan for what to do during subsequent patient visits, according to a study published today (Jan. 12) in Nature Communications.
Physicians who received notices containing additional planning guidance prescribed nearly 13% fewer opioids than letters that had been shown to be effective in improving prescribing safety. They also reduced prescriptions for anxiety drugs benzodiazepines by more than 8%. Together, these drugs make up the bulk of prescription drug overdoses.
The findings suggest this guidance, known as "if/when planning prompts," can reduce patient risk by reducing the intensity and frequency of these prescriptions. The findings also suggest that letters informing doctors of a patient's overdose death are more effective if they include instructional prompts.
The letter with a planning prompt asked doctors to implement a specific plan: "When your next patient presents with pain, please keep...(these)...recommendations handy to help them receive safe care. Additionally, feel free to express your concerns about prescription safety to them so that they, too, are aware of the dangers associated with scheduled drugs."
"Giving physicians a simple plan to guide their care appears to help reduce the use of these drugs," said Jason Doctor, lead author of the study and co-director of the Behavioral Sciences Program at the USC Schaeffer Center for Health Policy and Economics. "This is a promising approach to reducing fatal drug overdoses that is both affordable and scalable."
This study builds on two previous studies conducted by Dr. The first study found that doctors reduced opioid prescriptions by 10% within three months of receiving notification of a fatal overdose. A second study found that doctors prescribed 7% fewer opioids one year after receiving the notification. Letters used in these previous studies served as controls in this study.
"This latest research is part of an ongoing effort to better understand how to change the behavior of physicians whose patients have been negatively impacted by care provided by the medical community," said Dr.
The latest randomized study sent letters to 541 clinicians in Los Angeles County: 284 received a standard letter notifying them that a patient had died of an overdose; 257 received a letter with additional guidance.