Prescription Drug Monitoring Programs Produce a Limited Impact on Painkiller Prescribing in Medicare Part D

Yarbrough, Courtney R.

doi:10.1111/1475-6773.12652

Cited by 39 publications

(34 citation statements)

References 15 publications

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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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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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“…A PDMP is a database of certain prescribed and dispensed prescriptions by providers and pharmacies with the goals of monitoring prescribing patterns and doctor shopping behaviors to limit prescription drug misuse and diversion. These data were gathered from Yarbrough, which were originally gathered from the National Alliance for Model State Drug Laws (NAMSDL) and supplemented with additional state‐specific information. While some states have adopted subsequent regulations to their PDMPs such as mandatory use provisions, these policies are rather recent in our data period and vary with respect to which prescription substances trigger a mandated query of the PDMP and at what time intervals the PDMP must queried.…”

Section: Datamentioning

confidence: 99%

Section: Re Vie W Of E Xis Ting Liter Aturementioning

confidence: 99%

Good Samaritan harm reduction policy and drug overdose deaths

Atkins

Durrance

Kim³

2019

Health Services Research

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Objective To examine the effects of a harm reduction policy, specifically Good Samaritan (GS) policy, on overdose deaths. Data Sources/Study Setting Secondary data from multiple cause of death, mortality records paired with state harm reduction and substance use prevention policy. Study Design We estimate fixed effects Poisson count models to model the effect of GS policy on overdose deaths for all, prescription, and illicit drugs, controlled substances, and opioids, while controlling for other harm reduction and substance use prevention policies. Data Collection/Extraction Methods We merge secondary data sources by state and year between 1999 and 2016. Principal findings We fail to identify a statistically significant effect of GS policy in reducing overdose deaths broadly. Conclusions While we are unable to identify an effect of GS policy on overdose deaths, GS policy may have important effects on first‐stage outcomes not investigated in this paper. Given recent state policy changes and rapid increase in many categories of overdose deaths, additional research should continue to examine the implementation and effects of harm reduction policy specifically and substance use prevention policy broadly.

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“…5,6,7,8,9,10,11 One premise of these supply-side interventions is that they will decrease the number of individuals exposed to opioid analgesics and subsequently prevent individuals from developing an opioid use disorder (OUD), ultimately lowering the number of opioid overdose deaths. Previous studies have shown that such interventions may lead to a modest decrease in the prescription opioid supply, especially programs with enrollment and/or use mandates.…”

Section: Introductionmentioning

confidence: 99%

Prevention of Prescription Opioid Misuse and Projected Overdose Deaths in the United States

et al. 2019

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Key PointsQuestionWhat is the projected effect of lowering incident nonmedical prescription opioid use on the future trajectory of the opioid overdose crisis in the United States?FindingsIn this system dynamics model study, under current conditions, the opioid overdose crisis is expected to worsen—with the annual number of opioid overdose deaths projected to reach nearly 82 000 by 2025, resulting in approximately 700 000 deaths from 2016 to 2025. Interventions focused on lowering the incidence of prescription opioid misuse were projected to result in a 3.0% to 5.3% decrease in opioid overdose deaths over this period.MeaningPrevention of prescription opioid misuse alone is projected to have a modest effect on lowering opioid overdose deaths in the near future, and multipronged approach is needed to dramatically change the course of the epidemic.

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Prescription Drug Monitoring Programs Produce a Limited Impact on Painkiller Prescribing in Medicare Part D

Cited by 39 publications

References 15 publications

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

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

Good Samaritan harm reduction policy and drug overdose deaths

Prevention of Prescription Opioid Misuse and Projected Overdose Deaths in the United States

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