Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes: A Comparison of Program Users and Nonusers

Richard A. Deyo, Sara E. Hallvik, Christi Hildebran, Miguel Marino, Rachel Springer, Jessica M. Irvine, Nicole O'Kane, Joshua Van Otterloo, Dagan A. Wright, Gillian Leichtling, Lisa M. Millet, Jody Carson, Wayne Wakeland, Dennis McCarty

Research output: Contribution to journalArticle

17 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)166-177
Number of pages12
JournalJournal of Pain
Volume19
Issue number2
DOIs
StatePublished - Feb 2018

Keywords

  • Prescription drug monitoring program
  • cohort study
  • health policy
  • opioids
  • risky prescribing

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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    Deyo, R. A., Hallvik, S. E., Hildebran, C., Marino, M., Springer, R., Irvine, J. M., O'Kane, N., Van Otterloo, J., Wright, D. A., Leichtling, G., Millet, L. M., Carson, J., Wakeland, W., & McCarty, D. (2018). Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes: A Comparison of Program Users and Nonusers. Journal of Pain, 19(2), 166-177. https://doi.org/10.1016/j.jpain.2017.10.001