Impact of clinical decision support on controlled substance prescribing

Table 1 Characteristics of prescribing encounters (n = 2,321,059)

	#	%
Age of Patient
< 18 years	51,856	2.2
18–64	1,626,021	70.1
≥ 65	643,182	27.7
Facility Type
ED/Urgent Care	529,270	22.8
Inpatient Discharge	179,705	7.7
Other	24,132	1.0
Outpatient	1,587,952	68.4
Prescriber Type
Physician	1,520,158	65.5
Physician Assistant	439,310	18.9
Nurse Practitioner	338,762	14.6
Other/Unknown	22,829	1.0
Class of Drug
Opioid	1,755,360	75.6
Benzodiazepine	500,211	21.6
Both	65,487	2.8
Number of Criteria Met (n = 997,518)^a
0	730,763	73.3
1	194,104	19.5
2	57,671	5.8
3	13,479	1.4
≥4	1,501	0.2
Category of Criteria Met (n = 997,518)^a
Prescription with > 50% remaining (“early refill”)	83,697	8.4
2 + visits with Onsite Administration	12,071	1.2
3 + Prescriptions in past 30 Days	49,644	5.0
Positive Tox (any)	58,272	5.8
Previous Presentation for Overdose	10,532	1.1
Co-prescribed Benzos and Opioids	138,092	13.8
Extended Release	3,538	0.4
90-day	119,153	11.9
Naloxone	105,817	10.6
Medical Specialty
Behavioral Health	44,288	1.9
Cancer	55,847	2.4
Emergency/Urgent Care	469,110	20.2
Pain	303,130	13.1
Primary Care	986,039	42.5
Medical Specialty	86,864	3.7
Surgical Specialty	275,503	11.9
Long Term Care	900	0.04
Unknown	99,378	4.3
Duration
< 3 days	470,890	20.3
4–7 days	426,805	18.4
8–14 days	257,239	11.1
15–29 days	167,505	7.2
30–59 days	900,116	38.8
60 + days	98,502	4.2
MME (n = 1,820,848)^b
< 50	1,390,514	76.4
50–89	255,987	14.1
90 +	174,347	9.6

ED Emergency department, tox Toxicology, MME Morphine milligram equivalent
^aSince additional triggers were added to the alert during the study period, these were only described for the time period during which all interventions were live (10/17/2017–07/31/2019)
^bMME excludes benzodiazepine prescriptions and records where MME = 0 or where MME was missing

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