TY - JOUR
T1 - Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes
T2 - A Comparison of Program Users and Nonusers
AU - Deyo, Richard (Rick)
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
N1 - Funding Information:
Supported by grant number R01 DA031208 from the National Institute on Drug Abuse , and by Grant number UL 1RR024140 , from the National Center for Advancing Translational Sciences .
Publisher Copyright:
© 2017 The American Pain Society
PY - 2018/2
Y1 - 2018/2
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 - Prescription drug monitoring program
KW - cohort study
KW - health policy
KW - opioids
KW - risky prescribing
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U2 - 10.1016/j.jpain.2017.10.001
DO - 10.1016/j.jpain.2017.10.001
M3 - Article
C2 - 29054493
AN - SCOPUS:85036609231
VL - 19
SP - 166
EP - 177
JO - Journal of Pain
JF - Journal of Pain
SN - 1526-5900
IS - 2
ER -