PDM 2016
3rd Place Winner
Title:
Interprofessional
collaboration in the
emergency department to
reduce opioid prescribing
for dental pain patients.
Presenter:
Sara M. Barna, PharmD
University of Pittsburgh School of
Dental Medicine
Second-year Predoctoral Student
361 Darragh Street
Pittsburgh, PA 15213
724-678-5308
[email protected]
Authors:
Jean O’Donnell, DMD
University of Pittsburgh School of
Dental Medicine Associate Dean for
Academic Affairs
Marnie Oakley, DMD
University of Pittsburgh School of
Dental Medicine
Associate Dean for Clinical Affairs
Introduction:
There are approximately 2 million
non-traumatic dental pain patients
that are seen yearly in emergency
departments (EDs), representing
1.5% of the overallworkload. Yet,
many ED physicians perceive they
may not have sufficient training in
handling these emergencies. In the
absence of the proper equipment
and training to perform dental
services, ED physicians will likely turn
to prescribing pain medications to
help palliate dental pain. This
situation may foster prescribing
practices that can inadvertently
contribute to the opioid abuse
epidemic.
Methods:
A literature review was conducted
to further define ED physicians’
confidence in treating dental pain
patients and the results were
investigated to determine the
prevalence of opioid prescribing
practices to these patients.
Results:
Publications from 1985-2014 were
reviewed. Among the 750+ identified
publications, 8 addressed ED physicians’
perceived “lack of training” addressing
dental emergencies, noting the
majority of this group did not feel
comfortable in managing dental
patients.
Nine studies assessed the frequency
with which ED physicians prescribed
pain medications to dental patients.
Within these 9 studies, 5 specifically
reported that between 29.6% and
81% of dental pain patients treated
received an “opioid” or a “narcotic”
upon discharge.
Conclusions:
This review suggests ED physicians’
perceived training level in treating
dental pain is less than ideal. It also
confirms ED dental patients are
prescribed opioid and other narcotic
medications to treat dental pain.
Coupling these results with the
increased use, misuse, and abuse
of opioids suggests a call for ED
physicians to consider alternative
methods for pain control for these
patients that includes non-opioid
prescribing practices, as well as
training in the administration of local
anesthetic blocks in the oral cavity.
This call will necessitate fostering an
interprofessional relationship
between dentists and ED physicians
to offer the most appropriate care to
dental pain patients who present to
the ED.
Funding/Conflicts
of Interest:
No funding was required for this
study and there were no conflicts
to disclose.
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