Could Informing Doctors Of Patients' Opioid Deaths Curb Prescribing?

Could Informing Doctors Of Patients' Opioid Deaths Curb Prescribing?

By Beth Leipholtz 08/20/18
How are doctors' prescribing behavior affected when they're notified of their own patients' opioid-related deaths?
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doctor reading document in office

Some California doctors have recently received letters that changed how they prescribed opioids, according to new research.

The letters informed doctors of the deaths of patients to whom they had prescribed opioids, according to the Washington Post. Such letters were part of a study conducted by researchers at the University of Southern California and published Thursday (August 9) in the journal Science.

The letters were sent by the San Diego County Medical Examiner Office to hundreds of doctors who, in the past year, had prescribed opioids to a patient who later died.

“This is a courtesy communication to inform you that your patient [name, date of birth] died on [date]. Prescription drug overdose was either the primary cause of death or contributed to the death,” the letters read. "We hope that you will take this as an opportunity to join us in preventing future deaths from drug overdose.”

According to the Post, the idea behind the study was to close the gap between a doctor’s care and a doctor’s knowledge about the potential consequences of prescribing opioids.

While many doctors are aware that opioid use disorder is a widespread issue, they may believe that the consequences affect other doctors' patients rather than their own, the Post noted. 

According to the results of the study, doctors who learned of a patient’s death at the hands of opioids were 7% less likely to prescribe opioids to new patients. Doctors who received a letter also had a tendency to prescribe fewer high-dose prescriptions within the next three months  of receiving the letter. The total amount of opioids these doctors prescribed decreased by 9.7%. 

“What's particularly interesting to me is the personal nature of it,” Alexander Chiu, a surgeon at Yale New Haven Hospital who was not involved in the study, told the Post. “Depending on what field you're in, [the opioid epidemic] can feel a little remote. If you're not a pain doctor or a primary-care doctor, it's not quite as common to know or see your actions having a negative impact, which is what this is showing—it makes it very real. As evidence-based as we are as a profession, sometimes anecdotes can be really powerful.”

Lead researcher Jason Doctor, director of health informatics at the University of Southern California's Schaeffer Center for Health Policy and Economics, tells the Post that while doctors have knowledge of facts, they are still human.

“One of the takeaways I’d like people to have is that doctors learn a lot of clinical facts, but when it comes to clinical judgment and decision-making, they fall prey to the same biases that we all do,” he said. 

According to Doctor, San Diego County plans to continue sending these letters, and other counties have also said they are interested in doing something similar.

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Beth is a Minnesota girl who got sober at age 20. By day she is a website designer, and in her spare time she enjoys writing about recovery at www.lifetobecontinued.com, doing graphic design and spending time with her boyfriend and three dogs. Find Beth on LinkedInInstagram and Twitter.

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