Abstract
Prescription drug monitoring programs (PDMPs) are a response to the prescription opioid epidemic, but their effects on prescribing and health outcomes remain unclear, with conflicting reports. We sought to determine if prescriber use of Oregon's PDMP led to fewer high-risk opioid prescriptions or overdose events. We conducted a retrospective cohort study from October 2011 through October 2014, using statewide PDMP data, hospitalization registry, and vital records. Early PDMP registrants (n = 927) were matched with clinicians who never registered during the study period, using baseline prescribing metrics in a propensity score. Generalized estimating equations were used to examine prescribing trends after PDMP registration, using 2-month intervals. We found a statewide decline in measures of per capita opioid prescribing. However, compared with nonregistrants, PDMP registrants did not subsequently have significantly fewer patients receiving high-dose prescriptions, overlapping opioid and benzodiazepine prescriptions, inappropriate prescriptions, prescriptions from multiple prescribers, or overdose events. At baseline, frequent PDMP users wrote fewer high-risk opioid prescriptions than infrequent users; this persisted during follow-up with few significant group differences in trend. Thus, although opioid prescribing declined statewide after implementing the PDMP, registrants did not show greater declines than nonregistrants. Perspective: Factors other than PDMP use may have had greater influence on prescribing trends. Refinements in the PDMP program and related policies may be necessary to increase PDMP effects.
| Language | English (US) |
|---|---|
| Journal | Journal of Pain |
| DOIs | |
| State | Accepted/In press - Jan 1 2017 |
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Keywords
- Cohort study
- Health policy
- Opioids
- Prescription drug monitoring program
- Risky prescribing
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
- Anesthesiology and Pain Medicine
Cite this
Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes : A Comparison of Program Users and Nonusers. / Deyo, Richard A.; Hallvik, Sara E.; Hildebran, Christi; Marino, Miguel; Springer, Rachel; Irvine, Jessica M.; O'Kane, Nicole; Van Otterloo, Joshua; Wright, Dagan A.; Leichtling, Gillian; Millet, Lisa M.; Carson, Jody; Wakeland, Wayne; McCarty, Dennis.
In: Journal of Pain, 01.01.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes
T2 - Journal of Pain
AU - Deyo,Richard A.
AU - Hallvik,Sara E.
AU - Hildebran,Christi
AU - Marino,Miguel
AU - Springer,Rachel
AU - Irvine,Jessica M.
AU - O'Kane,Nicole
AU - Van Otterloo,Joshua
AU - Wright,Dagan A.
AU - Leichtling,Gillian
AU - Millet,Lisa M.
AU - Carson,Jody
AU - Wakeland,Wayne
AU - McCarty,Dennis
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Prescription drug monitoring programs (PDMPs) are a response to the prescription opioid epidemic, but their effects on prescribing and health outcomes remain unclear, with conflicting reports. We sought to determine if prescriber use of Oregon's PDMP led to fewer high-risk opioid prescriptions or overdose events. We conducted a retrospective cohort study from October 2011 through October 2014, using statewide PDMP data, hospitalization registry, and vital records. Early PDMP registrants (n = 927) were matched with clinicians who never registered during the study period, using baseline prescribing metrics in a propensity score. Generalized estimating equations were used to examine prescribing trends after PDMP registration, using 2-month intervals. We found a statewide decline in measures of per capita opioid prescribing. However, compared with nonregistrants, PDMP registrants did not subsequently have significantly fewer patients receiving high-dose prescriptions, overlapping opioid and benzodiazepine prescriptions, inappropriate prescriptions, prescriptions from multiple prescribers, or overdose events. At baseline, frequent PDMP users wrote fewer high-risk opioid prescriptions than infrequent users; this persisted during follow-up with few significant group differences in trend. Thus, although opioid prescribing declined statewide after implementing the PDMP, registrants did not show greater declines than nonregistrants. Perspective: Factors other than PDMP use may have had greater influence on prescribing trends. Refinements in the PDMP program and related policies may be necessary to increase PDMP effects.
AB - Prescription drug monitoring programs (PDMPs) are a response to the prescription opioid epidemic, but their effects on prescribing and health outcomes remain unclear, with conflicting reports. We sought to determine if prescriber use of Oregon's PDMP led to fewer high-risk opioid prescriptions or overdose events. We conducted a retrospective cohort study from October 2011 through October 2014, using statewide PDMP data, hospitalization registry, and vital records. Early PDMP registrants (n = 927) were matched with clinicians who never registered during the study period, using baseline prescribing metrics in a propensity score. Generalized estimating equations were used to examine prescribing trends after PDMP registration, using 2-month intervals. We found a statewide decline in measures of per capita opioid prescribing. However, compared with nonregistrants, PDMP registrants did not subsequently have significantly fewer patients receiving high-dose prescriptions, overlapping opioid and benzodiazepine prescriptions, inappropriate prescriptions, prescriptions from multiple prescribers, or overdose events. At baseline, frequent PDMP users wrote fewer high-risk opioid prescriptions than infrequent users; this persisted during follow-up with few significant group differences in trend. Thus, although opioid prescribing declined statewide after implementing the PDMP, registrants did not show greater declines than nonregistrants. Perspective: Factors other than PDMP use may have had greater influence on prescribing trends. Refinements in the PDMP program and related policies may be necessary to increase PDMP effects.
KW - Cohort study
KW - Health policy
KW - Opioids
KW - Prescription drug monitoring program
KW - Risky prescribing
UR - http://www.scopus.com/inward/record.url?scp=85036609231&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85036609231&partnerID=8YFLogxK
U2 - 10.1016/j.jpain.2017.10.001
DO - 10.1016/j.jpain.2017.10.001
M3 - Article
JO - Journal of Pain
JF - Journal of Pain
SN - 1526-5900
ER -