title: Has the rescheduling of hydrocodone changed ED prescribing practices?
abstract: OBJECTIVE
  The objective was to examine the effect of hydrocodone-containing product (HCP) rescheduling on the proportion of prescriptions for HCPs given to patients discharged from the emergency department (ED).
  
  
  METHODS
  Electronic queries of ED records were used to identify patients aged 15 years and older discharged with a pain-related prescription in the 12 months before and after HCP rescheduling. Prescriptions were classified as HCPs; other Schedule II medications (eg, oxycodone products); other Schedule III medications (eg, codeine products); and non-Schedule II/III products (eg, nonsteroidal anti-inflammatory drugs). We compared the proportions of patients receiving each type of prescription before and after rescheduling using χ2analysis and used logistic regression to explore the relationship between prescription type and time period while controlling for age, sex, race, and ethnicity.
  
  
  RESULTS
  Before rescheduling, 58.1% (95% confidence interval [CI], 57.4-58.7) of patients receiving a pain-related prescription received an HCP; after rescheduling, 13.2% (95% CI, 12.7-13.7) received an HCP (P < .001). Concurrently, other Schedule III prescriptions increased (pre: 11.7% [CI, 11.3-12.2] vs post: 44.9% [CI, 44.2-45.6], P < .001)), as did non-Schedule II/III prescriptions (pre: 51.8% [CI, 51.2-52.5] vs post: 59.3% [CI, 58.6-60.0], P < .001). When controlling for demographic characteristics, patients remained less likely to receive an HCP after rescheduling (adjusted odds ratio [AOR], 0.11; CI, 0.10-0.11) and more likely to receive other Schedule III (AOR, 6.1; CI, 5.8-6.5) and non-Schedule II/III (AOR, 1.4; CI, 1.3-1.4) products.
  
  
  CONCLUSIONS
  Rescheduling HCPs from Schedule III to Schedule II led to a substantial decrease in HCP prescriptions in our ED and an increase in prescriptions for other Schedule III and non-Schedule II/III products.
authors: Emergency Medicine Residency Program, University of Texas-Austin Dell Medical School/University Medical Center-Brackenridge, Austin, TX.
authors: Elizabeth C
authors: EC
authors: Oehler
authors: Emergency Medicine Residency Program, University of Texas-Austin Dell Medical School/University Medical Center-Brackenridge, Austin, TX. Electronic address: rlday2@gmail.com.
authors: Rachel L
authors: RL
authors: Day
authors: Analytics & Health Economics, Seton Healthcare Family, Austin, TX.
authors: David B
authors: DB
authors: Robinson
authors: Emergency Medicine Residency Program, University of Texas-Austin Dell Medical School/University Medical Center-Brackenridge, Austin, TX; Mount Isa Centre for Rural and Remote Health, James Cook University, Australia, Townsville, QLD Australia.
authors: Lawrence H
authors: LH
authors: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D061891:Controlled Substances; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004335:Drug and Narcotic Control; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D006853:Hydrocodone / Q000008:administration & dosage* / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D010351:Patient Discharge; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D061891:Controlled Substances; D006853:Hydrocodone