• Am J Emerg Med · Dec 2016

    Observational Study

    Has the rescheduling of hydrocodone changed ED prescribing practices?

    • Elizabeth C Oehler, Rachel L Day, David B Robinson, and Lawrence H Brown.
    • Emergency Medicine Residency Program, University of Texas-Austin Dell Medical School/University Medical Center-Brackenridge, Austin, TX.
    • Am J Emerg Med. 2016 Dec 1; 34 (12): 2388-2391.

    ObjectiveThe objective was to examine the effect of hydrocodone-containing product (HCP) rescheduling on the proportion of prescriptions for HCPs given to patients discharged from the emergency department (ED).MethodsElectronic queries of ED records were used to identify patients aged 15 years and older discharged with a pain-related prescription in the 12 months before and after HCP rescheduling. Prescriptions were classified as HCPs; other Schedule II medications (eg, oxycodone products); other Schedule III medications (eg, codeine products); and non-Schedule II/III products (eg, nonsteroidal anti-inflammatory drugs). We compared the proportions of patients receiving each type of prescription before and after rescheduling using χ(2) analysis and used logistic regression to explore the relationship between prescription type and time period while controlling for age, sex, race, and ethnicity.ResultsBefore rescheduling, 58.1% (95% confidence interval [CI], 57.4-58.7) of patients receiving a pain-related prescription received an HCP; after rescheduling, 13.2% (95% CI, 12.7-13.7) received an HCP (P < .001). Concurrently, other Schedule III prescriptions increased (pre: 11.7% [CI, 11.3-12.2] vs post: 44.9% [CI, 44.2-45.6], P < .001)), as did non-Schedule II/III prescriptions (pre: 51.8% [CI, 51.2-52.5] vs post: 59.3% [CI, 58.6-60.0], P < .001). When controlling for demographic characteristics, patients remained less likely to receive an HCP after rescheduling (adjusted odds ratio [AOR], 0.11; CI, 0.10-0.11) and more likely to receive other Schedule III (AOR, 6.1; CI, 5.8-6.5) and non-Schedule II/III (AOR, 1.4; CI, 1.3-1.4) products.ConclusionRescheduling HCPs from Schedule III to Schedule II led to a substantial decrease in HCP prescriptions in our ED and an increase in prescriptions for other Schedule III and non-Schedule II/III products.Copyright © 2016 Elsevier Inc. All rights reserved.

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