A study showed researchers hypothesized that an intervention asking emergency department (ED) providers to self?identify their opioid prescribing practices. Asking emergency department (ED) providers to self-identify their opioid prescribing practices and then providing them with timely, clinically relevant, individualized, and actionable feedback on their actual opioid prescribing data, significantly decreases future opioid prescribing among providers who underestimate their baseline prescribing. The study was published in Academic Emergency Medicine (AEM).

Little is known about the accuracy of provider self?perception of opioid prescribing. They hypothesized that an intervention asking emergency department (ED) providers to self?identify their opioid prescribing practices compared to group norms and subsequently providing them with their actual prescribing data would alter future prescribing compared to controls.

The study found that providers who initially underestimated opiate prescription rates had statistically significant decreases in opiate prescribing when compared to providers who were more accurate in initial self-assessment of prescribing rates. The randomized trial exposes important gaps in providers' self-perceptions of opioid prescribing and demonstrates that a simple, data-driven intervention using query-reveal methodology may decrease future prescribing, particularly among providers who underestimate their prescribing practices.

The findings suggest that current and future interventions in which provider adherence to guidelines is expected, including opioid interventions outside the emergency department and other quality and safety initiatives, should directly address the potential barrier of inaccurate provider self-awareness.

"The results have real-world applicability. A simple intervention enhancing safe prescribing is one of several opportunities the emergency physician has to combat the current opioid epidemic." Gail D'Onofrio, MD, MS, professor, and chair, Yale School of Medicine Department of Emergency Medicine, who is internationally known for her work in developing and testing interventions for department patients with unhealthy alcohol and other drug use.

Among 109 total participants, 51 were randomized to the intervention, 65% of whom underestimated their opioid prescribing. Intervention participants who underestimated their baseline prescribing had larger?magnitude decreases than controls (Hodges?Lehmann difference = –2.1 prescriptions per hundred patients at 6 months [95% confidence interval {CI} = –3.9 to –0.5] and –2.2 per hundred at 12 months [95% CI = –4.8 to –0.01]). Intervention participants who did not underestimate their prescribing had similar changes to controls.

Self?perception of prescribing was frequently inaccurate. Providing clinicians with their actual opioid prescribing data after querying their self?perception reduced future prescribing among providers who underestimated their baseline prescribing. Our findings suggest that guideline and policy interventions should directly address the potential barrier of inaccurate provider self?awareness.