EMR quantity autopopulation removal on hospital discharge prescribing patterns: Implications for opioid stewardship

What is Known and Objective Prescription drug stewardship is critical. Autopopulation(AP) of medication quantities may influence prescriber behaviour. We investigate the impact of AP removal(APR) on opioid prescribing. Methods Inpatient and emergency department(ED) discharges with opioid pain medications 2 years before and after APR were identified. Milligrams of morphine equivalents(MMEs) prescribed were recorded. Group comparisons were performed using Mann‐Whitney U tests. Spearman's rho was used to analyse correlations between pain level and quantity of prescribed opioids. Mann‐Kendall tests assessed trends in prescription patterns. Generalized estimating equations assessed trends in total quantity of prescribed MME. Results and Discussion A total of 53 608 patient encounters were included for analysis. In surgical patients, there were no trends in the frequency of prescriptions below, at or above the AP quantity pre‐APR. Post‐APR, there was a decrease in the percentage of prescriptions written for the AP quantity(τ = −.493, P = .001) and an increase in prescriptions for 30 tablets and a greater percentage of prescriptions for 30 tablets and resulted in an increase in larger prescriptions. Multivariate analysis of the total prescribed quantity of MME found no significant trend across months for inpatients prior to and after APR (0.997, P = .065 and 1.003, P = .142; respectively). The ED model found a monthly downward trend in amount of prescribed MME prior to and after APR (0.986, P