Limited use of opioid prescribing guidelines in Dutch emergency departments: results of a nationwide survey
Dublin Core
Title
Limited use of opioid prescribing guidelines in Dutch emergency departments: results of a nationwide survey
Subject
Emergency department, Opioids, Prescribing guidelines, Problematic opioid use, Opioid use disorder
Description
Background In recent years, the Netherlands has experienced a notable increase in opioid prescriptions and
associated fatalities. Emergency department (ED) patients exhibit relatively high rates of opioid use (15%) and misuse
(23% of patients who present to the ED and use prescription opioids test positive for misuse). To mitigate opioid-
related harm, the American College of Emergency Physicians (ACEP) advocates for the use of non-opioid analgesics
and minimal opioid prescriptions. In the Netherlands, the Society for Anesthesiology has issued a guideline for
appropriate opioid use, which are also relevant to EDs. However, the extent of implementation in EDs remains unclear.
This study utilized an online survey to assess the implementation of opioid-prescribing guidelines in Dutch EDs.
Chief medical officers from various EDs across the Netherlands were invited via email to complete questionnaires.
These questionnaires gathered general information about the EDs, details on the application of opioid-prescribing
guidelines, management of problematic opioid use, and specifics of the guidelines in practice.
Results Questionnaires were completed by chief medical officers from 33 Dutch EDs, yielding a 52.4% response rate.
Nineteen EDs (57.6%) used guidelines for opioid prescribing, predominantly local protocols, with only two of them
(10.5%) using the national guideline. The guidelines varied in content, with 68.4% advising on specific opioids (mainly
preferring oxycodone) and dosage, and in 63.2% giving advice on prescription duration (typically 3–7 days). Patient
education with opioid prescriptions was specified in the guidelines at 57.9% (11/19) of EDs, with brochures provided
at 17.6% (6/19) of EDs. The primary focus of patient education was on adverse effects, with addiction risks mentioned
at 36.4% (4/11) EDs.
Conclusions This study reveals significant variability and gaps in opioid prescribing guidelines across Dutch EDs.
Compared to US guidelines, Dutch practices are less cautious, highlighting the need for improvement. This study
underscores the necessity for a Dutch guideline tailored for EDs to manage opioid prescriptions and problematic
opioid use.
Keywords Emergency department, Opioids, Prescribing guidelines, Problematic opioid use, Opioid use disorder
associated fatalities. Emergency department (ED) patients exhibit relatively high rates of opioid use (15%) and misuse
(23% of patients who present to the ED and use prescription opioids test positive for misuse). To mitigate opioid-
related harm, the American College of Emergency Physicians (ACEP) advocates for the use of non-opioid analgesics
and minimal opioid prescriptions. In the Netherlands, the Society for Anesthesiology has issued a guideline for
appropriate opioid use, which are also relevant to EDs. However, the extent of implementation in EDs remains unclear.
This study utilized an online survey to assess the implementation of opioid-prescribing guidelines in Dutch EDs.
Chief medical officers from various EDs across the Netherlands were invited via email to complete questionnaires.
These questionnaires gathered general information about the EDs, details on the application of opioid-prescribing
guidelines, management of problematic opioid use, and specifics of the guidelines in practice.
Results Questionnaires were completed by chief medical officers from 33 Dutch EDs, yielding a 52.4% response rate.
Nineteen EDs (57.6%) used guidelines for opioid prescribing, predominantly local protocols, with only two of them
(10.5%) using the national guideline. The guidelines varied in content, with 68.4% advising on specific opioids (mainly
preferring oxycodone) and dosage, and in 63.2% giving advice on prescription duration (typically 3–7 days). Patient
education with opioid prescriptions was specified in the guidelines at 57.9% (11/19) of EDs, with brochures provided
at 17.6% (6/19) of EDs. The primary focus of patient education was on adverse effects, with addiction risks mentioned
at 36.4% (4/11) EDs.
Conclusions This study reveals significant variability and gaps in opioid prescribing guidelines across Dutch EDs.
Compared to US guidelines, Dutch practices are less cautious, highlighting the need for improvement. This study
underscores the necessity for a Dutch guideline tailored for EDs to manage opioid prescriptions and problematic
opioid use.
Keywords Emergency department, Opioids, Prescribing guidelines, Problematic opioid use, Opioid use disorder
Creator
Nicole Kraaijvanger1*, Cees Kramers2
, Albert Dahan3
and Arnt F. A. Schellekens4,5
, Albert Dahan3
and Arnt F. A. Schellekens4,5
Source
https://doi.org/10.1186/s12245-024-00799-8
Date
2024
Contributor
Peri Irawan
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Nicole Kraaijvanger1*, Cees Kramers2
, Albert Dahan3
and Arnt F. A. Schellekens4,5, “Limited use of opioid prescribing guidelines in Dutch emergency departments: results of a nationwide survey,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12554.