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. 2018 Nov:94:35-40.
doi: 10.1016/j.jsat.2018.08.006. Epub 2018 Aug 17.

Variations in prescription drug monitoring program use by prescriber specialty

Benjamin C Sun  1 , Nicoleta Lupulescu-Mann  2 , Christina J Charlesworth  2 , Hyunjee Kim  2 , Daniel M Hartung  3 , Richard A Deyo  4 , K John McConnell  5
Affiliations

Variations in prescription drug monitoring program use by prescriber specialty

Benjamin C Sun et al. J Subst Abuse Treat. 2018 Nov.

Abstract

Background: Although prescription drug monitoring programs (PDMPs) have been widely implemented to potentially reduce abuse of prescription opioids, there is limited data on variations in PDMP use by prescriber specialty. Such knowledge may guide targeted interventions to improve PDMP use.

Methods: Using data from Washington state Medicaid program, we performed a retrospective cohort study of opioid prescribers and their PDMP queries between Nov 1, 2013 and Oct 31, 2014. PDMP registration was mandatory for emergency physicians, but not for other providers. The unit of analysis was the prescriber. The primary outcome was any prescriber queries of the PDMP. We used multivariate regression models to identify variations in PDMP queries by prescriber specialty, as well as to explore explanatory pathways for observed variations.

Results: We studied 17,390 providers who prescribed opioids, including 8718 (50%) who were not registered with PDMP, 4767 (27%) who were registered but had no recorded use of the PDMP, and 3905 (23%) PDMP users (queries/user: median 18, IQR 5-64). Compared to general medicine physicians, PDMP use was higher for emergency physicians (OR 1.4, 95%CI: 1.2-1.7), and lower for surgical specialists (OR 0.1, 95%CI: 0.08-0.1), obstetrician-gynecologists (OR 0.2, 95%CI: 0.1-0.2) and dentists (OR 0.4, 95%CI: 0.4-0.5). Higher use by emergency physicians appeared to be mediated by higher registration rates, rather than by provider level predilection to use the PDMP.

Conclusions: A minority of opioid prescribers to Medicaid beneficiaries used the PDMP. We identified variations in PDMP use by prescriber specialty. Interventions to increase PDMP queries should target both PDMP registration and PDMP use after registration, as well as specialties with current low use rates.

Keywords: Prescription drug monitoring program.

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Conflict of interest statement

Conflict of Interest

The study team had full responsibility for the design of the study, in the collection, analysis, and interpretation of the data; in the preparation, review and approval of the study report. All the authors declare that they have no conflict interest.

Figures

Figure 1.
Figure 1.
Study Cohort
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References

    1. American College of Surgeons. Surgeon Stewardship of the Opioid Epidemic. (2017) Retrieved January 8, 2018, from https://www.facs.org/~/media/files/publications/bulletin/2017/2017%20aug...
    1. Baehren DF, Marco CA, Droz DE, Sinha S, Callan EM, & Akpunonu P (2010). A statewide prescription monitoring program affects emergency department prescribing behaviors. Ann Emerg Med, 56(1), 19–23 e11–13. doi: 10.1016/j.annemergmed.2009.12.011 - DOI - PubMed
    1. Bao Y, Pan Y, Taylor A, Radakrishnan S, Luo F, Pincus HA, & Schackman BR (2016). Prescription Drug Monitoring Programs Are Associated With Sustained Reductions In Opioid Prescribing By Physicians. Health Aff (Millwood), 35(6), 1045–1051. doi: 10.1377/hlthaff.2015.1673 - DOI - PMC - PubMed
    1. Brown R, Riley MR, Ulrich L, Kraly EP, Jenkins P, Krupa NL, & Gadomski A (2017). Impact of New York prescription drug monitoring program, I-STOP, on statewide overdose morbidity. Drug Alcohol Depend, 178, 348–354. doi: 10.1016/j.drugalcdep.2017.05.023 - DOI - PubMed
    1. Buchmueller TC, & Carey C (2017). The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare (Vol. Working Paper 23148). NBER Papers.

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