The impact of COVID-19 on analgesic prescribing in an urban emergency department

Abstract

Background

Providers across the country have significantly decreased opioid prescribing over the past decade to prevent opioid misuse. The COVID-19 pandemic led to a disruption of the healthcare system and changes in the relationships between patients and providers. Consequently, we sought to investigate whether the pandemic had any impact on analgesic prescribing in an urban emergency department.

Methods

This was a retrospective, single center study analyzing pharmacy records of patients that were treated with analgesics between January 2019 and May 2021. The most common analgesics utilized were tallied by month. Utilization of specific analgesics were compared between T₁-pre-COVID-19 (1/2019–1/2020) and T₂-post-COVID 19 (5/2020–5/2021). Analgesics were also categorized into broader categories (such as IV, oral, opioid, and non-opioid) and compared. Comparisons were analyzed using the t-test, Mann-Whitney u test, or chi-squared difference of proportions tests, as applicable.

Results

There were significant decreases in the amount of IV (7.2% vs. 6.5; p = 0.039) and oral opioid (2.6% vs. 2.1%; p = 0.001) administered during COVID-19. There were also decreases in the percent of patients given opioids (T₁: 6.7 vs. T₂: 4.6, p < 0.001). During COVID, there was an increase in the amount of non-opioid analgesics given per patient (p = 0.013). Particularly, there was an increase in the amount of oral non-opioid administrations per patient (p = 0.005). There was a decrease in utilization of ibuprofen between the two time periods (p < 0.001).

Conclusions

Despite the pandemic, providers continued to decrease opioid prescribing and increase non-opioid prescribing.

Keywords:

• COVID-19
• analgesics
• emergency department
• opioid prescribing

Authors’ contributions

CR: study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, statistical expertise.

JT: study concept and design, analysis and interpretation of data, drafting of manuscript, critical revision of manuscript for important intellectual content.

LN: study concept and design, critical revision of manuscript for important intellectual content.

Disclosure statement

CR, JT, LN report no conflicts of interest.

Presentations

This work has been presented in part at SAEM (Society of Academic Emergency Medicine) as a virtual poster presentation in May 2021.

Funding

The author(s) reported there is no funding associated with the work featured in this article.