Module 4: Therapeutics

Lesson 1

Need for judicious CDS prescribing

What are the driving factors behind the need for judicious CDS prescribing?

The problem of non-therapeutic use of prescription medications is well documented in Canada. In an Ontario-based study comparing 1991 and 2004 data on prescribing practices and deaths by overdose, 56% had been given a prescription opioid in the previous four weeks (Dhalla et al., 2009). There has been a commensurate 29% increase in prescribing opioid analgesics to community-dwelling Ontarians between 1991 and 2007, with prescriptions for oxycodone accounting for almost 20% of opioid prescriptions in 2007 (Dhalla et al., 2009). Similarly, a 250% increase has been documented in emergency department visits related to opioid withdrawal, overdose, intoxication, psychosis, and other issues in the five-year span between 2005-2006 and 2010-2011 (Expert Working Group on Narcotic Addiction, 2012).