Oxycodone prescribing in the emergency department during the opioid crisis. [EMA. 32 (Suppl 1)]

Abstract

Introduction: Misuse of prescription opioids is a significant public health issue in Australia with a rapid rise and an associated increase in overdose and death. The over-prescribing of oral opioids, especially oxycodone, in the emergency departments (EDs) has been identified as a contributor to this problem overseas. It is unclear if similar practice occurs in Australian EDs. Aim(s): The primary aim of our study was to identify the incidence of oral oxycodone administered to patients within the ED. The secondary outcome was to identify the incidence of oxycodone prescribed to patients on discharge from ED to the community. Method(s): Our study was designed as an observational, retrospective data analysis of the incidence of oxycodone prescribed within the three EDs of a large Australian public health service. All oral oxycodone prescribed over a four-year period (2015-2018) was included. Result(s): There were 890,557 presentations to ED during the period, which resulted in 228,242 episodes of opioid administration within the ED and 39,381 prescriptions for opioids provided on discharge. This was equivalent to 324 and 44 prescriptions per 1,000 presentations, respectively. The most frequently prescribed opioid medication in the ED was oxycodone immediate-release 5mg. 78.6% of discharge prescriptions generated were prescribed a maximum quantity of tablets allowable under the pharmaceutical benefits scheme. Conclusion(s): A concerningly large number of opioids were prescribed within the ED. An overuse of oxycodone may be contributing to adverse patient outcomes and a public health crisis. Hospitals should consider appropriate steps to reduce the incidence of opioid prescribing and the supply of these medications into the community.