Improving Transdermal Fentanyl Prescribing Practices Using Electronic Medical Record.

Abstract

Background: Transdermal (TD) fentanyl has a unique place in pain management that is not universally understood, thereby raising concerns for patient safety. This project aimed to improve TD fentanyl prescribing practices through an ordering algorithm in the electronic medical record (EMR). Measures: The main outcome measure was the percentage of erroneous TD fentanyl orders after EMR order implementation. Intervention: After a retrospective chart review to assess TD fentanyl orders, a root cause analysis led to the development and introduction of an enhanced ordering algorithm in EMR in January 2023, accompanied by pharmacy education. Outcomes: After the intervention, a review of TD fentanyl orders over five months showed a reduction in inappropriate ordering from 42.5% to 15.2%. Conclusions: Standardized EMR order sets, combined with provider education, hold promise for enhancing the quality and safety of chronic pain management with TD fentanyl.