By DoM Communications | Date published: May 19, 2025
Vandana Nagpal Works to Improve TD Fentanyl Prescribing Practices in Electronic Medical Records
Transdermal fentanyl (TD) plays an important role in the management of chronic, stable pain. However, its distinct properties set it apart from other commonly used opioid medications, and it continues to be prescribed in hospital or ambulatory settings by well-meaning providers who are not fully aware of its role in pain management. As a result, patients are being inadvertently exposed to life-threatening, avoidable adverse effects.
In a recent study published in the Journal of Palliative Medicine, Vandana Nagpal, MD, associate division chief and associate professor of medicine in the Division of Palliative Care, led a quality improvement project that involved changes to the electronic medical record order entry process. These changes resulted in a substantial and lasting reduction in the incorrect prescribing of TD fentanyl for hospitalized patients. Lessons learned from this inpatient initiative may guide ambulatory order entry processes as part of the ongoing efforts to alleviate patient risk from TD fentanyl.