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.