Highlights
- •Mandated prescription monitoring reduced opioid prescribing among emergency medicine providers.
- •There was heterogeneity in opioid prescribing across hospitals and by patient diagnosis.
- •Reductions in opioid prescriptions could help curb the opioid epidemic.
Abstract
Prescription drug monitoring programs (PDMPs) enable registered prescribers to obtain
real-time information on patients' prescription history of controlled medications.
We sought to describe the effect of a state-mandated PDMP on opioid prescribing by
emergency medicine providers. We retrospectively analyzed electronic medical records
of 122,732 adult patients discharged with an opioid prescription from 15 emergency
departments in a single health system in Pennsylvania from July 2015 to March, 2017.
We used an interrupted time series design to evaluate the percentage of patients discharged
each month with an opioid prescription before and after state law-mandated PDMP use
on August 25, 2016. From August (pre-PDMP) to September, 2016 (post-PDMP), the opioid
prescribing rate decreased from 12.4% (95% confidence interval [CI], 10.8%-14.1%)
to 10.2% (95% CI, 8.8%-11.8%). For each month between September 2016 to March 2017,
there was a mean decline of .46% (95% CI, −.38% to −.53%) in the percentage of patients
discharged with an opioid prescription. There was heterogeneity in opioid prescribing
across hospitals as well as according to patient diagnosis.
Perspective
This study examined the effect of a state-mandated PDMP on opioid prescribing among
emergency medicine providers from 15 different hospitals in a single health system.
Findings support current PDMP mandates in reducing opioid prescriptions, which could
curb the prescription opioid epidemic and may ultimately reduce abuse, misuse, and
overdose death.
Key words
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Article info
Publication history
Published online: December 11, 2017
Accepted:
November 28,
2017
Received in revised form:
November 14,
2017
Received:
August 7,
2017
Footnotes
Research funding was provided by an internal grant from the Department of Emergency Medicine at the University of Pittsburgh. B. Suffoletto is supported by a K23 from NIAAA (AA023284-01).
The authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
Copyright
© 2017 by the American Pain Society
