Effect of Automated Prescription Drug Monitoring Program Queries on Emergency Department Opioid Prescribing

Sun, Benjamin; Charlesworth, Christina J.; Lupulescu-Mann, Nicoleta; Young, J. Isaac; Kim, Hyunjee; Hartung, Daniel; Deyo, Richard A.; McConnell, K. John

doi:10.1016/j.annemergmed.2017.10.023

Cited by 32 publications

(45 citation statements)

References 34 publications

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“…35,36 However, automated use of PDMPs may not curb opioid prescribing. 37 Finally, facilitylevel policies can also be a way to disseminate and implement national guidelines by addressing nuances not covered by regional or national policies. For example, St. Joseph's hospital in Patterson, NJ has developed specific protocols for use in the ED that focus on lowering the use of opioids.…”

Section: Discussionmentioning

confidence: 99%

Emergency department provider and facility variation in opioid prescriptions for discharged patients

Ward

Jenkins

et al. 2019

The American Journal of Emergency Medicine

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There was substantial physician and facility variation in opioid prescription for discharged adult ED patients. Emergency physicians were less likely to prescribe opioids when their workload was lower, and this effect diminished at high workload levels. Understanding situational and other factors that explain this variation is important given the rising U.S. opioid epidemic and the need for urgent intervention.

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Section: Discussionmentioning

confidence: 99%

Emergency department provider and facility variation in opioid prescriptions for discharged patients

Ward

Jenkins

et al. 2019

The American Journal of Emergency Medicine

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“…We excluded the following studies from Table because they evaluated PDMP provisions, not overall PDMPs, or compared robust to nonrobust PDMPs: Brown et al, 2017; Gilson et al., 2011; Green et al., 2012; Haffajee et al., 2018; Kuo et al., 2016; Pardo et al., 2016; Phillips et al., 2017; Rasubala et al., 2015; Ringwalt et al., 2015; Sigler et al., 1984; Suffoletto et al., 2018; Sun et al., 2017; Wastila et al., 1996; Wen et al., 2017; and Yarbrough et al., 2018 . See Online Appendix for a detailed summary of these evaluations.…”

Section: Resultsmentioning

confidence: 99%

The Association of State Opioid Misuse Prevention Policies With Patient‐ and Provider‐Related Outcomes: A Scoping Review

2019

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This scoping review reveals a growing literature on the effects of certain state opioid misuse prevention policies, but persistent gaps in evidence on other prevalent state policies remain. Policymakers interested in reducing the volume and dosage of opioids prescribed and dispensed can consider adopting robust prescription drug monitoring programs with mandatory access provisions and drug supply management policies, such as prior authorization policies for high‐risk prescription opioids. Further research should concentrate on potential unintended consequences of opioid misuse prevention policies, differential policy effects across populations, interventions that have not received sufficient evaluation (eg, Good Samaritan laws, naloxone access laws), and patient‐related outcomes. Context In the midst of an opioid crisis in the United States, an influx of state opioid misuse prevention policies has provided new opportunities to generate evidence of policy effectiveness that can inform policy decisions. We conducted a scoping review to synthesize the available evidence on the effectiveness of US state interventions to improve patient and provider outcomes related to opioid misuse and addiction. Methods We searched six online databases to identify evaluations of state opioid policies. Eligible studies examined legislative and administrative policy interventions that evaluated (a) prescribing and dispensing, (b) patient behavior, or (c) patient health. Findings Seventy‐one articles met our inclusion criteria, including 41 studies published between 2016 and 2018. These articles evaluated nine types of state policies targeting opioid misuse. While prescription drug monitoring programs (PDMPs) have received considerable attention in the literature, far fewer studies addressed other types of state policy. Overall, evidence quality is very low for the majority of policies due to a small number of evaluations. Of interventions that have been the subject of considerable research, promising means of reducing the volume and dosages of opioids prescribed and dispensed include drug supply management policies and robust PDMPs. Due to low study number and quality, evidence is insufficient to draw conclusions regarding interventions targeting patient behavior and health outcomes, including naloxone access laws and Good Samaritan laws. Conclusions Recent research has improved the evidence base on several state interventions targeting opioid misuse. Specifically, moderate evidence suggests that drug supply management policies and robust PDMPs reduce opioid prescribing. Despite the increase in rigorous evaluations, evidence remains limited for the majority of policies, particularly those targeting patient health–related outcomes.

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“…While these data do not reveal what is causing the increases and decreases in rates or elasticity, one hypothesis is that the impact of supply side policy interventions such as establishment of prescription drug monitoring programs (PDMP), increased law enforcement ( Dowell et al, 2016 , National Alliance for Model State Drug Laws, 2016 , Rutkow et al, 2015 , Office of National Drug Control Policy, 2018 ), drug take back programs ( Gray and Hagemeier, 2012 , Fass, 2011 ), and dose limit laws may be underlying factors ( Barth et al, 2017 , Davis et al, 2018 Nov 3 , National Conference of State Legislators, 2018 ). Previous research indicates that these approaches may have a moderate effect (3.0–5.3% reduction) on fatal opioid overdose ( Bao et al, 2016 , Brady et al, 2014 , Moyo et al, 2017 , Yarbrough, 2018 , Wen et al, 2017 , Sun et al, 2018 , Haffajee et al, 2018 ). However, it is unclear what the effect of these interventions may have been on fatal overdose rates.…”

Section: Discussionmentioning

confidence: 99%

Modeling dynamics of fatal opioid overdose by state and across time

Cooper

Thompson

Edgerton

et al. 2020

Preventive Medicine Reports

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Effect of Automated Prescription Drug Monitoring Program Queries on Emergency Department Opioid Prescribing

Abstract: An automated prescription drug monitoring program query intervention was not associated with reductions in ED opioid prescribing or quantities, even in patients with previous high-risk opioid use.

Cited by 32 publications

References 34 publications

Emergency department provider and facility variation in opioid prescriptions for discharged patients

Emergency department provider and facility variation in opioid prescriptions for discharged patients

The Association of State Opioid Misuse Prevention Policies With Patient‐ and Provider‐Related Outcomes: A Scoping Review

Modeling dynamics of fatal opioid overdose by state and across time

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