Can Pharmacist Email Alerts Reduce Concurrent Prescribing of Opioids, Benzodiazepines?

Pharmacist email alerts to practitioners regarding opioids and benzodiazepines failed to detectably reduce concurrent prescribing, providing evidence that alternative approaches are needed, according to study findings published in JAMA Health Forum.

Researchers conducted a randomized clinical trial between 2019 and 2021 of patients and their practitioners (primary care managers and prescribers) in the National Capital Region of the Military Health System.

Email alerts were sent by clinical pharmacists with standardized messages designed to increase awareness of guidelines, facilitate coordination between practitioners, and provide action steps and resources.

Of 2237 patients recently coprescribed opioids and benzodiazepines, 1187 were assigned to treatment, 1050 to control, and 1275 (57%) were women. In the 90 days before enrollment, patients received a mean (SD) of 31 (44) days of opioids and 33 (34) days of benzodiazepines.

“There were no detected differences in the primary end points, including patients’ receipt of opioids (adjusted difference, 1.1 days; 95% CI, -∞ to 3.0; P = .81), benzodiazepines (adjusted difference, -0.6 days; 95% CI, -∞ to 1.4; P = .30), and opioids and benzodiazepines together (adjusted difference, -0.1 days; 95% CI, -∞ to 0.7; P = .41),” reported researchers.

Of 789 practitioners eligible for emails, 429 were considered the treatment group, 325 were considered controls, and 35 were excluded, reported researchers.  

According to study results, in practitioners’ total prescribing of opioids, benzodiazepines, or both drug classes together no differences were detected.

“Combining randomization with quality improvement activities may help stakeholders seeking evidence-based interventions to encourage guideline-concordant care,” concluded study authors.

Reference:
Sacarny A, Safran E, Steffel M, et al. Effect of pharmacist email alerts on concurrent prescribing of opioids and benzodiazepines by prescribers and primary care managers a randomized clinical trial. JAMA Health Forum. 2022;3(9):e223378. doi:10.1001/jamahealthforum.2022.3378