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Associations between statewide prescription drug monitoring program (PDMP) requirement and physician patterns of prescribing opioid analgesics for patients with non-cancer chronic pain.
Addict Behav. 2018 Jan; 76:348-354.AB

Abstract

OBJECTIVE

State-level prescription drug monitoring programs (PDMPs) have been implemented in most states. PDMPs enable registered prescribers to obtain real-time information on patients' prescription history to reduce non-medical use of controlled drugs. This study examined whether PDMP implementation and different levels of PDMP requirements were associated with physicians' patterns of prescribing opioid analgesics for patients with non-cancer chronic pain.

METHODS

This is a secondary analysis study using cross-sectional national data. Patients with non-cancer chronic pain from the 2012 National Ambulatory Medical Care Survey were included (weighted N=81,018,131; unweighted N=3295). Heckman two-step selection procedure employing two logistic regressions was used to explore the associations between PDMP requirements and physicians' prescribing behaviors, controlling for physician characteristics, patient characteristics, physician-healthcare system interaction, and physician-patient relationship, guided by the Eisenberg's model of physician decision making.

RESULTS

State PDMP implementation status and requirement levels were not associated with physician opioid prescribing for non-cancer chronic pain treatment (p's ranged 0.30-0.32). Patients with Medicare coverage were more likely to be prescribed opioid analgesics than those with private health insurance (OR=1.55, p<0.01). Hispanic patients were less likely to be prescribed opioid analgesics than non-Hispanic white patients (OR=0.61, p<0.05).

CONCLUSIONS

Findings indicated that the effectiveness of PDMPs on physicians' opioid prescribing tendency for non-cancer chronic pain treatment could not be supported. Policy makers should be aware of the need for redesigning PDMPs regarding requirements and enforcement for prescribers and related stakeholders. Future studies also are needed to identify characteristics contributing to PDMP effectiveness in reducing non-medical use of prescription opioids.

Authors+Show Affiliations

Department of Applied Health Science, School of Public Health, Indiana University, 1025 E. 7th Street, SPH 116, Bloomington, IN 47405, USA. Electronic address: linhsi@indiana.edu.Department of Applied Health Science, School of Public Health, Indiana University, 1025 E. 7th Street, SPH 116, Bloomington, IN 47405, USA. Electronic address: zw34@indiana.edu.Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls, Ann Arbor, MI 48109, USA. Electronic address: caroboyd@med.umich.edu.Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, 20 North Pine Street, Baltimore, MD 21201, USA. Electronic address: lsimoniw@rx.umaryland.edu.Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls, Ann Arbor, MI 48109, USA. Electronic address: buu@umich.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28898808

Citation

Lin, Hsien-Chang, et al. "Associations Between Statewide Prescription Drug Monitoring Program (PDMP) Requirement and Physician Patterns of Prescribing Opioid Analgesics for Patients With Non-cancer Chronic Pain." Addictive Behaviors, vol. 76, 2018, pp. 348-354.
Lin HC, Wang Z, Boyd C, et al. Associations between statewide prescription drug monitoring program (PDMP) requirement and physician patterns of prescribing opioid analgesics for patients with non-cancer chronic pain. Addict Behav. 2018;76:348-354.
Lin, H. C., Wang, Z., Boyd, C., Simoni-Wastila, L., & Buu, A. (2018). Associations between statewide prescription drug monitoring program (PDMP) requirement and physician patterns of prescribing opioid analgesics for patients with non-cancer chronic pain. Addictive Behaviors, 76, 348-354. https://doi.org/10.1016/j.addbeh.2017.08.032
Lin HC, et al. Associations Between Statewide Prescription Drug Monitoring Program (PDMP) Requirement and Physician Patterns of Prescribing Opioid Analgesics for Patients With Non-cancer Chronic Pain. Addict Behav. 2018;76:348-354. PubMed PMID: 28898808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations between statewide prescription drug monitoring program (PDMP) requirement and physician patterns of prescribing opioid analgesics for patients with non-cancer chronic pain. AU - Lin,Hsien-Chang, AU - Wang,Zhi, AU - Boyd,Carol, AU - Simoni-Wastila,Linda, AU - Buu,Anne, Y1 - 2017/09/05/ PY - 2017/06/07/received PY - 2017/08/17/revised PY - 2017/08/29/accepted PY - 2017/9/13/pubmed PY - 2018/6/12/medline PY - 2017/9/13/entrez KW - Ambulatory care KW - Chronic pain KW - Drug abuse KW - Drug policy KW - Prescription drug SP - 348 EP - 354 JF - Addictive behaviors JO - Addict Behav VL - 76 N2 - OBJECTIVE: State-level prescription drug monitoring programs (PDMPs) have been implemented in most states. PDMPs enable registered prescribers to obtain real-time information on patients' prescription history to reduce non-medical use of controlled drugs. This study examined whether PDMP implementation and different levels of PDMP requirements were associated with physicians' patterns of prescribing opioid analgesics for patients with non-cancer chronic pain. METHODS: This is a secondary analysis study using cross-sectional national data. Patients with non-cancer chronic pain from the 2012 National Ambulatory Medical Care Survey were included (weighted N=81,018,131; unweighted N=3295). Heckman two-step selection procedure employing two logistic regressions was used to explore the associations between PDMP requirements and physicians' prescribing behaviors, controlling for physician characteristics, patient characteristics, physician-healthcare system interaction, and physician-patient relationship, guided by the Eisenberg's model of physician decision making. RESULTS: State PDMP implementation status and requirement levels were not associated with physician opioid prescribing for non-cancer chronic pain treatment (p's ranged 0.30-0.32). Patients with Medicare coverage were more likely to be prescribed opioid analgesics than those with private health insurance (OR=1.55, p<0.01). Hispanic patients were less likely to be prescribed opioid analgesics than non-Hispanic white patients (OR=0.61, p<0.05). CONCLUSIONS: Findings indicated that the effectiveness of PDMPs on physicians' opioid prescribing tendency for non-cancer chronic pain treatment could not be supported. Policy makers should be aware of the need for redesigning PDMPs regarding requirements and enforcement for prescribers and related stakeholders. Future studies also are needed to identify characteristics contributing to PDMP effectiveness in reducing non-medical use of prescription opioids. SN - 1873-6327 UR - https://www.unboundmedicine.com/medline/citation/28898808/Associations_between_statewide_prescription_drug_monitoring_program__PDMP__requirement_and_physician_patterns_of_prescribing_opioid_analgesics_for_patients_with_non_cancer_chronic_pain_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0306-4603(17)30330-1 DB - PRIME DP - Unbound Medicine ER -