An Experimental Test of the Effectiveness of Unsolicited Reporting by a Prescription Drug Monitoring Program in Reducing Inappropriate Acquisition of Opioids

McDonald, Douglas; Carlson, Kenneth E.; Jalbert, Sarah Kuck

doi:10.1093/pm/pny095

Cited by 13 publications

(17 citation statements)

References 19 publications

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“…92,93 Six studies found that mandatory use of PDMPs, including unsolicited and proactive reporting of patient prescription histories, improved opioid-related outcomes. [94][95][96][97][98][99] ThesepositivefindingsonstrongPDMPswere notuniform:1studyfoundnosignificantassociationbetween mandatory use requirements and the number of opioid prescriptions among patients undergoing general surgical procedures 100 and another study found that strong and weak PDMPs were associated with similar changes in opioid prescription rates, the number of cumulative doses, and prescriptionlength(indays)amongMedicarebeneficiaries. 101 Studies published after our review period investigated GoodSamaritanlaws,painclinicandmarijuanaregulations, prescribing guidelines, and educational interventions.…”

Section: Discussionmentioning

confidence: 94%

“…emergency department visits resulting in opioid prescriptions or prescribed MME in Washington State. 42 These differences may have been the result of state PDMP characteristics, such as different methods of automated reporting and/or analytic designs (eg, the study of unsolicited PDMP reporting in Nevada used propensity score matching 33 ).PDMPeffectivenessmaychangeovertime:a 4-state study found an immediate decline in the percentage ofpersonsfillingopioidprescriptionsafterimplementation of robust PDMPs that mandate access, monitor multiple drug schedules, and update data regularly, but only 1 state saw a sustainedeffect. 28 Some evidence suggests that PDMPs result in increased heroin use, presumably because opioid users will substitute heroin for opioids.…”

Section: Impact Of Systems-level Interventions On Opioid Use Overdosmentioning

confidence: 99%

“…40 States with mandatory PDMPs (vs states without mandatory PDMPs) reported reduced volume of opioid prescriptions filled among Medicaid enrollees 43 and reduced opioid misuse among Medicare Part D beneficiaries. 24 Unsolicited or automated reporting of PDMP data led to a significantreductioninthenumberofprescriptionsandtotal MME prescribed in Massachusetts 46 yetithadnoeffecton the same measures in Nevada 33 or on the proportion of PDMPs are state programs that require pharmacies to submit information on any controlled substance prescriptions electronically to health departments or pharmacy boards. This information is used to identify health care provider overprescription or patient overuse of controlled substances.…”

Section: Impact Of Systems-level Interventions On Opioid Use Overdosmentioning

confidence: 99%

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A Rapid Review of the Impact of Systems-Level Policies and Interventions on Population-Level Outcomes Related to the Opioid Epidemic, United States and Canada, 2014-2018

et al. 2020

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Objectives In the United States, rising rates of overdose deaths and recent outbreaks of hepatitis C virus and HIV infection are associated with injection drug use. We updated a 2014 review of systems-level opioid policy interventions by focusing on evidence published during 2014-2018 and new and expanded opioid policies. Methods We searched the MEDLINE database, consistent with the 2014 review. We included articles that provided original empirical evidence on the effects of systems-level interventions on opioid use, overdose, or death; were from the United States or Canada; had a clear comparison group; and were published from January 1, 2014, through July 19, 2018. Two raters screened articles and extracted full-text data for qualitative synthesis of consistent or contradictory findings across studies. Given the rapidly evolving field, the review was supplemented with a search of additional articles through November 17, 2019, to assess consistency of more recent findings. Results The keyword search yielded 535 studies, 66 of which met inclusion criteria. The most studied interventions were prescription drug monitoring programs (PDMPs) (59.1%), and the least studied interventions were clinical guideline changes (7.6%). The most common outcome was opioid use (77.3%). Few articles evaluated combination interventions (18.2%). Study findings included the following: PDMP effectiveness depends on policy design, with robust PDMPs needed for impact; health insurer and pharmacy benefit management strategies, pill-mill laws, pain clinic regulations, and patient/health care provider educational interventions reduced inappropriate prescribing; and marijuana laws led to a decrease in adverse opioid-related outcomes. Naloxone distribution programs were understudied, and evidence of their effectiveness was mixed. In the evidence published after our search’s 4-year window, findings on opioid guidelines and education were consistent and findings for other policies differed. Conclusions Although robust PDMPs and marijuana laws are promising, they do not target all outcomes, and multipronged interventions are needed. Future research should address marijuana laws, harm-reduction interventions, health insurer policies, patient/health care provider education, and the effects of simultaneous interventions on opioid-related outcomes.

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Section: Discussionmentioning

confidence: 94%

Section: Impact Of Systems-level Interventions On Opioid Use Overdosmentioning

confidence: 99%

Section: Impact Of Systems-level Interventions On Opioid Use Overdosmentioning

confidence: 99%

See 1 more Smart Citation

A Rapid Review of the Impact of Systems-Level Policies and Interventions on Population-Level Outcomes Related to the Opioid Epidemic, United States and Canada, 2014-2018

et al. 2020

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“…The extracted data from the included studies were then classified into main conceptual categories and summarised to align with the scoping review objective and research questions. The data extraction results are presented in Tables S1 and S2 [18–166], Supporting Information.…”

Section: Resultsmentioning

confidence: 99%

Mapping the research addressing prescription drug monitoring programs: A scoping review

Hoppe

Karimi

Khalil

2022

Drug and Alcohol Review

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Issues. Prescription drug monitoring programs are a harm minimisation intervention and clinical decision support tool that address the public health concern surrounding prescription drug misuse. Given the large number of studies published to date and the ongoing implementation of these programs, it is important to map the literature and identify areas for further research to improve practice. Approach. A scoping review was undertaken to identify the research on prescription drug monitoring programs published between January 2015 and April 2021. Key Findings. A total of 153 citations were included in this scoping review. The majority of the studies originated from the USA and were quantitative. Results on program effectiveness are mixed and mainly examine their association with opioid-related outcomes. Unintended consequences are revealed in the literature and this review also highlights barriers to program use. Implications. Overall, findings are mixed despite the large number of studies published to date. Mapping the literature identifies priority areas for further research that can advise policymakers and clinicians on practice improvement. Conclusion. Results on prescription drug monitoring program effectiveness are mixed and mainly examine their association with opioid-related outcomes. This review highlights barriers to prescription drug monitoring program effectiveness related to program use and system integration. Further research is needed in these areas to improve prescription drug monitoring program use and patient outcomes.

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“…Our findings are consistent with research that has found a reduction in risky prescribing practices after receipt of unsolicited reports from the PDMP. 54,55 However, proactive PDMPs were associated with higher rates of overdose from synthetic opioids other than methadone. The last period of study (2010-2016) coincided with a shift in the profile of the opioid overdose epidemic, so that illegally produced synthetic opioids such as fentanyl and related analogs broadly contaminated the illegal opioid supply and became the leading type of opioid involved in overdose deaths.…”

Section: Discussionmentioning

confidence: 99%

Measuring Relationships Between Proactive Reporting State-level Prescription Drug Monitoring Programs and County-level Fatal Prescription Opioid Overdoses

et al. 2020

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Background: Prescription drug monitoring programs (PDMPs) that collect and distribute information on dispensed controlled substances have been adopted by nearly all US states. We know little about program characteristics that modify PDMP impact on prescription opioid overdose deaths. Methods:We measured associations between adoption of any PDMP and changes in fatal prescription opioid overdoses in 2002-2016 across 3,109 counties in 49 states. We then measured changes related to the adoption of "proactive PDMPs", which report outlying prescribing/ dispensing patterns and provide broader access to PDMP data by law enforcement. Comparisons were made within three time intervals that broadly represent the evolution of PDMPs (2002-2004, 2005-2009, 2010-2016). We modeled overdoses using Bayesian space-time models.Results: Adoption of electronic PDMP access was associated with 9% lower rates of fatal prescription opioid overdoses after three years (rate ratio [RR]=0.91, 95% credible interval [CI]: 0.88-0.93) with well-supported effects for methadone (RR=0.86, CI: 0.82-0.90) and other synthetic opioids (RR=0.82, CI: 0.77-0.86). Compared to states with no/weak PDMPs, proactive PDMPs were associated with fewer deaths attributed to natural/semi-synthetic opioids *

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An Experimental Test of the Effectiveness of Unsolicited Reporting by a Prescription Drug Monitoring Program in Reducing Inappropriate Acquisition of Opioids

Abstract: Requiring prescribers to solicit patients' prescription histories is likely to be a more effective use of PDMP resources than proactive notification.

Cited by 13 publications

References 19 publications

A Rapid Review of the Impact of Systems-Level Policies and Interventions on Population-Level Outcomes Related to the Opioid Epidemic, United States and Canada, 2014-2018

A Rapid Review of the Impact of Systems-Level Policies and Interventions on Population-Level Outcomes Related to the Opioid Epidemic, United States and Canada, 2014-2018

Mapping the research addressing prescription drug monitoring programs: A scoping review

Measuring Relationships Between Proactive Reporting State-level Prescription Drug Monitoring Programs and County-level Fatal Prescription Opioid Overdoses

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