title: Care plans reduce ED visits in those with drug-seeking behavior.
abstract: Patients with drug-seeking behavior can be both labor and resource intensive to the emergency department (ED).
  
  
  OBJECTIVE
  To determine the effectiveness of ED care plans for individuals at high risk for drug-seeking behavior on ED visits.
  
  
  METHODS
  A retrospective, cohort observational study.
  
  
  METHODS
  A suburban teaching hospital with an annual census of 80,000 patients. The number of ED visits was determined 1 year before and 2 subsequent years following care plan initiation.
  
  
  METHODS
  Unclaimed letter, incomplete data, and/or non-drug-seeking care plan.
  
  
  METHODS
  Two-tailed Wilcoxon signed-rank test with significance of P < .05.
  
  
  RESULTS
  Sixty patients were enrolled and 7 were excluded, leaving 53 patients for analysis. Mean annual visits before care plan initiation were 7.6 (95% confidence interval [CI], 6.3-9.1). One year following implementation, mean visits decreased to 2.3 (95% CI, 1.5-3.1) (P ≤ .0001). Two years following implementation, mean visits continued to decline to 1.5 (95% CI, 0.9-2.1) (P ≤ .0001). A significant reduction in visits occurred 1 and 2 years following care plan implementation.
  
  
  CONCLUSIONS
  Emergency department care plans are an effective method to reduce ED visits in those with drug-seeking behavior.
authors.affiliation: Morristown Medical Center, Department of Emergency Medicine, Morristown, NJ. Electronic address: ffiesseler@yahoo.com.
authors.forename: Frederick
authors.initials: F
authors.lastname: Fiesseler
authors.affiliation: Rutgers Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, NJ.
authors.forename: Renee
authors.initials: R
authors.lastname: Riggs
authors.affiliation: Morristown Medical Center, Department of Emergency Medicine, Morristown, NJ.
authors.forename: David
authors.initials: D
authors.lastname: Salo
authors.affiliation: Morristown Medical Center, Department of Emergency Medicine, Morristown, NJ.
authors.forename: Richard
authors.initials: R
authors.lastname: Klemm
authors.affiliation: Morristown Medical Center, Department of Emergency Medicine, Morristown, NJ.
authors.forename: Ashley
authors.initials: A
authors.lastname: Flannery
authors.affiliation: Charles E Schmidt College of Medicine Florida Atlantic University, Department of Integrated Medical Science, Boca Raton, FL.
authors.forename: Richard
authors.initials: R
authors.lastname: Shih
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000188:drug therapy / Q000523:psychology*; D058999:Drug-Seeking Behavior; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D000069342:Medical Overuse / Q000517:prevention & control*; D010347:Patient Care Planning; D012189:Retrospective Studies