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; Otterloo, Joshua Van; Wright, Dagan; Leichtling, Gillian; Millet, Lisa M.; Carson, Jody; Wakeland, Wayne W.; McCarty, Dennis

doi:10.1016/j.jpain.2017.10.001

Cited by 51 publications

(40 citation statements)

References 31 publications

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“…Recent studies support the efficacy of PDMP in reducing opioid shopping behavior and overdose events(Bao et al, 2016; Buchmueller & Carey, 2017;Moyo et al, 2017; Patrick, Fry, Jones, & Buntin, 2016; Wen, Schackman, Aden, & Bao, 2017), although these findings are not universal. (Deyo et al, 2017; Nam, Shea, Shi, & Moran, 2017; Sun, Charlesworth, et al, 2017; Yarbrough, 2017) PDMP characteristics such as mandatory registration(Wen et al, 2017), mandatory use(Brown et al, 2017; Buchmueller & Carey, 2017; Pardo, 2016; Suffoletto, Lynch, Pacella, Yealy, & Callaway, 2017), clinical decision support, and monitoring of high risk activity(Pardo, 2016) are associated with greater efficacy. Several studies also suggest that providers alter prescribing behavior when given unsolicited PDMP data.…”

Section: Discussionmentioning

confidence: 99%

Variations in prescription drug monitoring program use by prescriber specialty

Sun

Lupulescu-Mann

Charlesworth

et al. 2018

Journal of Substance Abuse Treatment

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Section: Discussionmentioning

confidence: 99%

Variations in prescription drug monitoring program use by prescriber specialty

Sun

Lupulescu-Mann

Charlesworth

et al. 2018

Journal of Substance Abuse Treatment

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“…23 In Florida, PDMP implementation was associated with decreased oxycodone-related overdose mortality 25 ; in Oregon, a higher number of overdoses occurred among patients of PDMP-registered physicians than among patients of clinicians who did not register for PDMPs. 26 Although 1 study found no effect of PDMPs on the rate of fatal drug overdoses in the US general population 35 PDMPs were associated with an increased risk of fatal overdose in 17 states. 29 Robust PDMP policies were associated with greater overdose mortality protection among states with PDMPs (vs states without PDMPs).…”

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

confidence: 93%

“…PDMPs. We found little consensus on the effectiveness of PDMPs.Althoughseveralstudiesfoundnoeffectonopioid prescribing and use after PDMP implementation 21,26,[30][31][32] opioid prescription rates declined in Iowa 39 and pharmacists' self-reported dispensing decreased in Indiana. 36 One study reported a 12.5% reduction in potentially inappropriate opioid prescriptions to Ontario residents with publicly funded drug insurance after implementation of a narcotic drug monitoring program.…”

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

confidence: 99%

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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“…PMPs have existed in the US for decades, and while successful at reducing the prescribed medications being monitored [45], have not convincingly addressed the underlying harms or problematic prescribing practices as intended [46][47][48][49]. Although primarily targeting prescription opioids, evidence indicates that when PMPs include BDZs they are also ineffective at reducing BDZ-related deaths [50,51].…”

Section: Prescription Monitoring Programs: Impacts and Implicationsmentioning

confidence: 99%

Beyond Prescriptions Monitoring Programs: The Importance of Having the Conversation about Benzodiazepine Use

Oldenhof

Anderson-Wurf²,

Hall

et al. 2019

JCM

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Internationally there is an escalation of prescription-related overdose deaths, particularly related to benzodiazepine use. As a result, many countries have implemented prescription monitoring programs (PMPs) to increase the regulation of benzodiazepine medications. PMPs centralize prescription data for prescribers and pharmacists and generate alerts to high-doses, risky combinations, or multiple prescribers with the aim to reduce inappropriate prescribing and subsequently the potential of patient harm. However, it has become clear that prescribers have been provided with minimal guidance and insufficient training to effectively integrate PMP information into their decision making around prescribing these medications. Accordingly, this paper discusses how PMPs have given rise to a range of unintended consequences in those who have been prescribed benzodiazepines (BDZs). Given that a gradual taper is generally required to mitigate withdrawal from BDZs, there are concerns that alerts from PMPs have resulted in BDZs being ceased abruptly, resulting in a range of unintended harms to patients. It is argued that best practice guidelines based upon a patient-centered framework of decision-making, need to be developed and implemented, in order to curtail the unintended consequences of PMPs. This paper outlines some key considerations when starting the conversation with patients about their BDZ use.

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

Abstract: 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.

Cited by 51 publications

References 31 publications

Variations in prescription drug monitoring program use by prescriber specialty

Variations in prescription drug monitoring program use by prescriber specialty

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

Beyond Prescriptions Monitoring Programs: The Importance of Having the Conversation about Benzodiazepine Use

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