Descriptive Study of Opioid-Acetaminophen Prescription Patterns at the Providence VA Medical Center

摘要

Background: Prescription opioid-acetaminophen productsaccount for the majority of cases of acetaminophen-relatedacute liver failure in the United States. We sought toexamine the frequency of opioid-acetaminophen overuseat the Providence VA Medical Center and improve thequality and safety of opioid-acetaminophen prescriptionpractices in a system employing electronic health recordsand e-prescribing.Results: During fiscal year 2011, the Providence VA pharmacydispensed a total of 19,841 acetaminophen prescriptionsto a total of 4455 different patients. There were only15 acetaminophen prescriptions dispensed in excess of 4g/day, and there were only 14 patients exposed to a potentialmaximum daily dose of acetaminophen greater than 4g.Conclusions: The Providence VAMC appears to have alow rate of prescription acetaminophen misuse, in contrastto rates seen in previous studies. The VHA electronichealth record, accessible to all healthcare providers,appears to offer considerable benefit in reducing theoveruse of acetaminophen containing opioid products.