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Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes: A Comparison of Program Users and Nonusers.
J Pain. 2018 02; 19(2):166-177.JP

Abstract

Prescription drug monitoring programs (PDMPs) are a response to the prescription opioid epidemic, but their effects on prescribing and health outcomes remain unclear, with conflicting reports. We sought to determine if prescriber use of Oregon's PDMP led to fewer high-risk opioid prescriptions or overdose events. We conducted a retrospective cohort study from October 2011 through October 2014, using statewide PDMP data, hospitalization registry, and vital records. Early PDMP registrants (n = 927) were matched with clinicians who never registered during the study period, using baseline prescribing metrics in a propensity score. Generalized estimating equations were used to examine prescribing trends after PDMP registration, using 2-month intervals. We found a statewide decline in measures of per capita opioid prescribing. However, compared with nonregistrants, PDMP registrants did not subsequently have significantly fewer patients receiving high-dose prescriptions, overlapping opioid and benzodiazepine prescriptions, inappropriate prescriptions, prescriptions from multiple prescribers, or overdose events. At baseline, frequent PDMP users wrote fewer high-risk opioid prescriptions than infrequent users; this persisted during follow-up with few significant group differences in trend. Thus, although opioid prescribing declined statewide after implementing the PDMP, registrants did not show greater declines than nonregistrants.

PERSPECTIVE

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.

Authors+Show Affiliations

Department of Family Medicine, Oregon Health & Science University, Portland, Oregon; Department of Medicine and The Oregon Institute for Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon. Electronic address: deyor@ohsu.edu.HealthInsight Oregon, Portland, Oregon.HealthInsight Oregon, Portland, Oregon.Department of Family Medicine, Oregon Health & Science University, Portland, Oregon; Oregon Health & Science University - Portland State University School of Public Health, Oregon Health & Science University, Portland, Oregon.Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.Propeller Consulting, Portland, Oregon.HealthInsight Oregon, Portland, Oregon.Injury and Violence Prevention Program for the State of Oregon, Portland, Oregon.Injury and Violence Prevention Program for the State of Oregon, Portland, Oregon.HealthInsight Oregon, Portland, Oregon.Injury and Violence Prevention Program for the State of Oregon, Portland, Oregon.HealthInsight Oregon, Portland, Oregon.Department of Systems Science, Portland State University, Portland, Oregon.Oregon Health & Science University - Portland State University School of Public Health, Oregon Health & Science University, Portland, Oregon.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

29054493

Citation

Deyo, Richard A., et al. "Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes: a Comparison of Program Users and Nonusers." The Journal of Pain : Official Journal of the American Pain Society, vol. 19, no. 2, 2018, pp. 166-177.
Deyo RA, Hallvik SE, Hildebran C, et al. Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes: A Comparison of Program Users and Nonusers. J Pain. 2018;19(2):166-177.
Deyo, R. A., Hallvik, S. E., Hildebran, C., Marino, M., Springer, R., Irvine, J. M., O'Kane, N., Van Otterloo, J., Wright, D. A., Leichtling, G., Millet, L. M., Carson, J., Wakeland, W., & McCarty, D. (2018). Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes: A Comparison of Program Users and Nonusers. The Journal of Pain : Official Journal of the American Pain Society, 19(2), 166-177. https://doi.org/10.1016/j.jpain.2017.10.001
Deyo RA, et al. Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes: a Comparison of Program Users and Nonusers. J Pain. 2018;19(2):166-177. PubMed PMID: 29054493.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes: A Comparison of Program Users and Nonusers. AU - Deyo,Richard A, AU - Hallvik,Sara E, AU - Hildebran,Christi, AU - Marino,Miguel, AU - Springer,Rachel, AU - Irvine,Jessica M, AU - O'Kane,Nicole, AU - Van Otterloo,Joshua, AU - Wright,Dagan A, AU - Leichtling,Gillian, AU - Millet,Lisa M, AU - Carson,Jody, AU - Wakeland,Wayne, AU - McCarty,Dennis, Y1 - 2017/10/18/ PY - 2017/06/14/received PY - 2017/09/06/revised PY - 2017/10/11/accepted PY - 2017/10/22/pubmed PY - 2019/10/23/medline PY - 2017/10/22/entrez KW - Prescription drug monitoring program KW - cohort study KW - health policy KW - opioids KW - risky prescribing SP - 166 EP - 177 JF - The journal of pain : official journal of the American Pain Society JO - J Pain VL - 19 IS - 2 N2 - : Prescription drug monitoring programs (PDMPs) are a response to the prescription opioid epidemic, but their effects on prescribing and health outcomes remain unclear, with conflicting reports. We sought to determine if prescriber use of Oregon's PDMP led to fewer high-risk opioid prescriptions or overdose events. We conducted a retrospective cohort study from October 2011 through October 2014, using statewide PDMP data, hospitalization registry, and vital records. Early PDMP registrants (n = 927) were matched with clinicians who never registered during the study period, using baseline prescribing metrics in a propensity score. Generalized estimating equations were used to examine prescribing trends after PDMP registration, using 2-month intervals. We found a statewide decline in measures of per capita opioid prescribing. However, compared with nonregistrants, PDMP registrants did not subsequently have significantly fewer patients receiving high-dose prescriptions, overlapping opioid and benzodiazepine prescriptions, inappropriate prescriptions, prescriptions from multiple prescribers, or overdose events. At baseline, frequent PDMP users wrote fewer high-risk opioid prescriptions than infrequent users; this persisted during follow-up with few significant group differences in trend. Thus, although opioid prescribing declined statewide after implementing the PDMP, registrants did not show greater declines than nonregistrants. PERSPECTIVE: 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. SN - 1528-8447 UR - https://www.unboundmedicine.com/medline/citation/29054493/Association_of_Prescription_Drug_Monitoring_Program_Use_With_Opioid_Prescribing_and_Health_Outcomes:_A_Comparison_of_Program_Users_and_Nonusers_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1526-5900(17)30736-8 DB - PRIME DP - Unbound Medicine ER -