Table 3.

Treatment and Intervention Studies

Author/Year/Study Location	Sample Source, Design, Length of Follow up	N	Objective	Measurement	Results	Author’s Conclusion	Relevance for Primary Care	Risk of Bias
Gugelmann et.al, 2013, United States35	Patients in two urban EDs who are prescribed opioids from the ED assessed during a Pre-intervention (6–9 months) and Post-intervention (8–11 months) period at 2 tertiary care urban EDs (a primary and affiliate hospital) at different times, Prospective study (Primary Hospital January 2012–August 2012 and affiliate hospital September 2011–August 2012)	N= 40,554 pre-intervention and 30,958 post intervention at the primary hospital N = 18,000 pre-intervention and 27,143 post-intervention at the affiliate hospital At both hospitals, for persons age ≥ 65, N = 1360 pre-intervention and 852 post-intervention	To determine if multidisciplinary educational intervention (lectures, journal clubs, case discussions, and EMR decision support tool) would decrease ED opioid packs (4 tablets of Oxycodone 5mg-Acetaminophen 325) dispensed at discharge.	1. Pre-intervention and post-intervention change in opioid discharge packs dispensed to all patients treated and discharged through August 2012. 2. Analysis of change in opioid dispensing among patients with known risk factors (<65 yo, history of substance abuse, chronic pain or psychiatric disorder) for Rx opioid dependence	1. Overall discharge packs decreased by 39.6% at primary hospital and 56.2% at the affiliate hospital. 2. For persons age ≥ 65 yo, 210/1360 (15.4%) were given an opioid pack at pre-intervention. 83/852 (9.7%) were given an opioid pack post-intervention.	Interventions were associated with a decrease in the number of opioid packs dispensed and also in the number ordered for those with risk factors.	Providing education to prescribers can influence the trends in prescriptions and help prevent misuse and comorbidity.	It is difficult to assess the true efficacy of the intervention without a control group.