A typology of prescription drug monitoring programs: a latent transition analysis of the evolution of programs from 1999 to 2016

Smith, Nigel; Martins, Sílvia S.; Kim, June; Rivera‐Aguirre, Ariadne; Fink, David S.; Castillo‐Carniglia, Álvaro; Henry, Stephen G.; Mooney, Stephen J.; Marshall, Brandon D. L.; Davis, Corey S.; Cerdá, Magdalena

doi:10.1111/add.14440

Cited by 27 publications

(45 citation statements)

References 27 publications

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“…Others have hypothesized that states initially implement PDMPs or strengthen existing programs in response to relatively high opioid morbidity and mortality experienced in the state . This potentially bidirectional relationship may explain our results of more prevalent high dose prescribing in states with high program strength than in non‐PDMP states.…”

Section: Discussionmentioning

confidence: 83%

“…Increases in the number of states newly operating PDMPs or enhancing existing programs could be partly attributed to increased state and federal appropriations for this purpose. Due to continued evolution of state PDMPs beyond our study period, their strength is likely to have developed even further in more recent years …”

Section: Discussionmentioning

confidence: 95%

“…Our study has limitations. First, our study may not represent the current status of PDMPs because these programs may have evolved since 2012 . Nonetheless, we assess a period prior to the intensification of co‐occurring opioid policies that might bias estimates of PDMP impact.…”

Section: Discussionmentioning

confidence: 99%

“…Another study measured PDMP strength through a composite score of several operational characteristics and found states with more robust PDMPs had fewer opioid overdose deaths than states with weaker programs . An analysis of the evolution of PDMPs from 1999 to 2016 found an overall trend toward state adoption of more comprehensive PDMP legislation, and suggests the level of PDMP robustness within a given time interval is related to exacerbated prescription opioid overdose rates in preceding years . Recent reforms to strengthen PDMPs have seen several states replace voluntary access to PDMPs with mandates for providers to query the databases prior to prescribing .…”

Section: Introductionmentioning

confidence: 99%

“…8 An analysis of the evolution of PDMPs from 1999 to 2016 found an overall trend toward state adoption of more comprehensive PDMP legislation, and suggests the level of PDMP robustness within a given time interval is related to exacerbated prescription opioid overdose rates in preceding years. 16 Recent reforms to strengthen PDMPs have seen several states replace voluntary access to PDMPs with mandates for providers to query the databases prior to prescribing. 17 An evaluation of these "must access" provisions among the Medicare population reported protective effects on opioid oversupply and multiple provider episodes, and found negative but statistically insignificant associations with prescription opioid overdoses.…”

Section: Introductionmentioning

confidence: 99%

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Prescription drug monitoring programs: Assessing the association between “best practices” and opioid use in Medicare

Moyo

Simoni

Griffin

et al. 2019

Health Services Research

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Objective To estimate the impact of implementing prescription drug monitoring program (PDMP) best practices on prescription opioid use. Data Sources 2007–2012 Medicare claims for noncancer pain patients, and PDMP attributes from the Prescription Drug Abuse Policy System. Study Design We derived PDMP composite scores using the number of best practices adopted by states (range: 0‐14), classifying states as either no PDMP, low strength (0 < score < median), or high strength (score ≥ median). Using generalized linear models, we quantified the association between the PDMP score category and opioid use measures—overall and stratified by disability/age. Sensitivity analyses assessed the general Medicare sample regardless of pain diagnoses, individual PDMP characteristics, and compared GEE model findings to models with state fixed effects. Principal Findings Compared to non‐PDMP states, strong PDMP states had lower opioid cumulative doses (−296 mg; 95% CI: −512, −132), days supplied (−7.84; 95% CI: −10.6, −5.04), prescription fill rates (0.97; 95% CI: 0.95, 0.98), and mean daily doses (−2.31 mg; 95% CI: −3.14, −1.48) but greater prevalence of high opioid doses in disabled adults, whereas there was little or no change in older adults. Findings in states with weak PDMPs were substantively similar to those of strong PDMPs. Results from sensitivity analyses were mostly consistent with main findings except there was a null relationship with mean daily doses and high doses in models with state fixed effects. Conclusions Comprehensive or minimal adoption of PDMP best practices was associated with mostly comparable effects on Medicare beneficiaries’ opioid use; however, these effects were concentrated among nonelderly disabled adults.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prescription drug monitoring programs: Assessing the association between “best practices” and opioid use in Medicare

Moyo

Simoni

Griffin

et al. 2019

Health Services Research

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Methodological challenges and proposed solutions for evaluating opioid policy effectiveness

Schuler

Griffin

Cerdá

et al. 2020

Health Serv Outcomes Res Method

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Scaling Interventions to Manage Chronic Disease: Innovative Methods at the Intersection of Health Policy Research and Implementation Science

et al. 2022

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Policy implementation is a key component of scaling effective chronic disease prevention and management interventions. Policy can support scale-up by mandating or incentivizing intervention adoption, but enacting a policy is only the first step. Fully implementing a policy designed to facilitate implementation of health interventions often requires a range of accompanying implementation structures, like health IT systems, and implementation strategies, like training. Decision makers need to know what policies can support intervention adoption and how to implement those policies, but to date research on policy implementation is limited and innovative methodological approaches are needed. In December 2021, the Johns Hopkins ALACRITY Center for Health and Longevity in Mental Illness and the Johns Hopkins Center for Mental Health and Addiction Policy convened a forum of research experts to discuss approaches for studying policy implementation. In this report, we summarize the ideas that came out of the forum. First, we describe a motivating example focused on an Affordable Care Act Medicaid health home waiver policy used by some US states to support scale-up of an evidence-based integrated care model shown in clinical trials to improve cardiovascular care for people with serious mental illness. Second, we define key policy implementation components including structures, strategies, and outcomes. Third, we provide an overview of descriptive, predictive and associational, and causal approaches that can be used to study policy implementation. We conclude with discussion of priorities for methodological innovations in policy implementation research, with three key areas identified by forum experts: effect modification methods for making causal inferences about how policies’ effects on outcomes vary based on implementation structures/strategies; causal mediation approaches for studying policy implementation mechanisms; and characterizing uncertainty in systems science models. We conclude with discussion of overarching methods considerations for studying policy implementation, including measurement of policy implementation, strategies for studying the role of context in policy implementation, and the importance of considering when establishing causality is the goal of policy implementation research.

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A typology of prescription drug monitoring programs: a latent transition analysis of the evolution of programs from 1999 to 2016

Cited by 27 publications

References 27 publications

Prescription drug monitoring programs: Assessing the association between “best practices” and opioid use in Medicare

Prescription drug monitoring programs: Assessing the association between “best practices” and opioid use in Medicare

Methodological challenges and proposed solutions for evaluating opioid policy effectiveness

Scaling Interventions to Manage Chronic Disease: Innovative Methods at the Intersection of Health Policy Research and Implementation Science

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