Effects of mandatory prescription drug monitoring program (PDMP) use laws on prescriber registration and use and on risky prescribing

Gail K Strickler; Kun Zhang; John F Halpin; Amy S B Bohnert; Grant T Baldwin; Peter W Kreiner

doi:10.1016/j.drugalcdep.2019.02.010

Effects of mandatory prescription drug monitoring program (PDMP) use laws on prescriber registration and use and on risky prescribing

Drug Alcohol Depend. 2019 Jun 1:199:1-9. doi: 10.1016/j.drugalcdep.2019.02.010. Epub 2019 Mar 22.

Authors

Gail K Strickler¹, Kun Zhang², John F Halpin², Amy S B Bohnert³, Grant T Baldwin², Peter W Kreiner⁴

Affiliations

¹ Institute for Behavioral Health, Brandeis University, Waltham, MA, USA. Electronic address: [email protected].
² Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
³ Department of Psychiatry, University of Michigan and VA Center for Clinical Management Research, University of Michigan North Campus Research Complex, 2800 Rd., Bldg. 16, Room 227W, Ann Arbor, MI, 48109, USA.
⁴ Institute for Behavioral Health, Brandeis University, Waltham, MA, USA.

PMID: 30954863
DOI: 10.1016/j.drugalcdep.2019.02.010

Abstract

Background: Comprehensive mandatory use laws for prescription drug monitoring programs (PDMPs) have been implemented in a number of states to help address the opioid overdose epidemic. These laws may reduce opioid-related overdose deaths by increasing prescribers' use of PDMPs and reducing high-risk prescribing behaviors.

Methods: We used state PDMP data to examine the effect of these mandates on prescriber registration, use of the PDMP, and on prescription-based measures of patient risk in three states-Kentucky, Ohio, and West Virginia-that implemented mandates between 2010 and 2015. We conducted comparative interrupted time series analyses to examine changes in outcome measures after the implementation of mandates in the mandate states compared to control states.

Results: Mandatory use laws increased prescriber registration and utilization of the PDMP in the mandate states compared to controls. The multiple provider episode rate, rate of opioid prescribing, rate of overlapping opioid prescriptions, and rate of overlapping opioid/benzodiazepine prescriptions decreased in Kentucky and Ohio. Nevertheless, the magnitude of changes in these measures varied among mandates states.

Conclusions: These findings indicate that PDMP mandates have the potential to reduce risky opioid prescribing practices. Variation in the laws may explain why the effectiveness varied between states.

Keywords: Opioids; Prescriber mandates; Prescription drug monitoring programs.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Analgesics, Opioid / therapeutic use
Benzodiazepines / therapeutic use
Drug Overdose / epidemiology
Drug Overdose / prevention & control
Health Personnel / legislation & jurisprudence*
Health Personnel / standards
Humans
Inappropriate Prescribing / legislation & jurisprudence*
Inappropriate Prescribing / prevention & control
Interrupted Time Series Analysis / legislation & jurisprudence
Interrupted Time Series Analysis / methods
Kentucky / epidemiology
Morpholines / therapeutic use
Ohio / epidemiology
Practice Patterns, Physicians' / legislation & jurisprudence*
Practice Patterns, Physicians' / standards
Prescription Drug Monitoring Programs / legislation & jurisprudence*
Prescription Drug Monitoring Programs / standards
West Virginia / epidemiology

Substances

Analgesics, Opioid
Morpholines
Benzodiazepines
RV 538