J Med Syst - Opioid prescribing by physicians with and without electronic health records.

Tópicos

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Resumo

CKGROUND: Physicians in the U.S. are adopting electronic health records (EHRs) at an unprecedented rate. However, little is known about how EHR use relates to physicians' care decisions. Using nationally representative data, we estimated how using practice-based EHRs relates to opioid prescribing in primary care.METHODS: This study analyzed 33,090 visits to primary care physicians (PCPs) in the 2007-2010 National Ambulatory Medical Care Survey. We used logistic regression to compare opioid prescribing by PCPs with and without EHRs.RESULTS: Thirteen percent of all visits and 33?% of visits for chronic noncancer pain resulted in an opioid prescription. Compared to visits without EHRs, visits to physicians with EHRs had 1.38 times the odds of an opioid prescription (95?% CI, 1.22-1.56). Among visits for chronic noncancer pain, physicians with EHRs had significantly higher odds of an opioid prescription (adj. OR=1.39; 95?% CI, 1.03-1.88). Chronic pain visits involving electronic clinical notes were also more likely to result in an opioid prescription compared to chronic pain visits without (adj. OR=1.51; 95?% CI, 1.10-2.05). Chronic pain visits involving electronic test ordering were also more likely to result in an opioid prescription compared to chronic pain visits without (adj. OR=1.31; 95?% CI, 1.01-1.71).CONCLUSIONS: We found higher levels of opioid prescribing among physicians with EHRs compared to those without. These results highlight the need to better understand how using EHR systems may influence physician prescribing behavior so that EHRs can be designed to reliably guide physicians toward high quality care.

Resumo Limpo

ckground physician us adopt electron health record ehr unpreced rate howev littl known ehr use relat physician care decis use nation repres data estim use practicebas ehr relat opioid prescrib primari caremethod studi analyz visit primari care physician pcps nation ambulatori medic care survey use logist regress compar opioid prescrib pcps without ehrsresult thirteen percent visit visit chronic noncanc pain result opioid prescript compar visit without ehr visit physician ehr time odd opioid prescript ci among visit chronic noncanc pain physician ehr signific higher odd opioid prescript adj ci chronic pain visit involv electron clinic note also like result opioid prescript compar chronic pain visit without adj ci chronic pain visit involv electron test order also like result opioid prescript compar chronic pain visit without adj ci conclus found higher level opioid prescrib among physician ehr compar without result highlight need better understand use ehr system may influenc physician prescrib behavior ehr can design reliabl guid physician toward high qualiti care

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