NCJ Number
252563
Journal
Pain Medicine Volume: 19 Issue: 7 Dated: July 2018 Pages: 1396-1407
Date Published
July 2018
Length
12 pages
Annotation
This exploratory research evaluated the impact of unsolicited reports sent by Massachusetts' prescription drug monitoring program (PDMP) to the prescribers of persons with multiple provider episodes (MPEs), also referred to as doctor/pharmacy shopping, which is an indicator of prescription drug abuse and/or diversion.
Abstract
ABST Although unsolicited reporting by PDMPs to prescribers of opioid analgesics is thought to be an important practice in reducing MPEs and the potential harm associated with them, evidence of its effectiveness is mixed. In the current study, individuals with MPEs were identified from PDMP records between January 2010 and July 2011 as individuals having Schedule II prescriptions (at least one prescription being an opioid) from four or more distinct prescribers and four or more distinct pharmacies within 6 months. Based on available MA-PDMP resources, an unsolicited report containing the patient's 12-month prescription history was sent to prescribers of a subset of patients who met the MPE threshold; a comparison group closely matched on demographics and baseline prescription history, whose prescribers were not sent a report, was generated using propensity score matching. The prescription history of each group was examined for 12 months before and after the intervention. The study determined there were 84 patients (intervention group) whose prescribers received an unsolicited report and 504 matched patients (comparison group) whose prescribers were not sent a report. Regression analyses indicated significantly greater decreases in the number of Schedule II opioid prescriptions (P < 0.01), number of prescribers visited (P < 0.01), number of pharmacies used (P < 0.01), dosage units (P < 0.01), total days' supply (P < 0.01), total morphine milligram equivalents (MME; P < 0.01), and average daily MME (P < 0.05) for the intervention group relative to the comparison group. A post hoc analysis suggested that the observed intervention effects were greater for individuals with an average daily dose of less than 100 MMEs. This study suggests that PDMP unsolicited reporting to prescribers can help reduce risk measures in patients' prescription histories, which may improve health outcomes for patients receiving opioid analgesics from multiple providers. (publisher abstract modified)