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北卡罗来纳州处方药监测计划对该州医疗服务提供者处方行为的影响。

The effects of North Carolina's prescription drug monitoring program on the prescribing behaviors of the state's providers.

作者信息

Ringwalt Chris, Garrettson Mariana, Alexandridis Apostolos

机构信息

Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC, USA,

出版信息

J Prim Prev. 2015 Apr;36(2):131-7. doi: 10.1007/s10935-014-0381-0.

Abstract

State-level prescription drug monitoring programs (PDMPs) show promise as a key strategy to respond to the epidemic of the misuse and abuse of controlled substances (CS), particularly opioid analgesics, in the United States. Undocumented concerns have been expressed that these PDMPs may have a "chilling effect" on providers' willingness to prescribe these substances to their patients. Using data from North Carolina's PDMP for the 3-year period from 2009 through 2011, we examined whether rapid increases in (1) the number of providers who queried the system, and (2) the number of days on which they queried it, would be related to their prescribing practices in regards to CS. We hypothesized that neither marker of PDMP utilization would be associated with a decrease in either patients receiving CS prescriptions or CS prescriptions filled. We found no association between either of these variables and the number of patients who filled prescriptions for CS or the number of prescriptions for CS filled. However, we did find a slight positive relationship between the growth in the utilization of the PDMP and the number of prescriptions filled for opioid analgesics. Concerns that PDMPs may constrain prescribing behavior with regards to CS are not supported.

摘要

国家级处方药监测项目(PDMPs)有望成为应对美国受控物质(CS)滥用和误用流行问题的一项关键策略,尤其是阿片类镇痛药。有人曾表达过未经证实的担忧,认为这些PDMPs可能会对医疗服务提供者给患者开具这些药物的意愿产生“寒蝉效应”。利用北卡罗来纳州PDMP在2009年至2011年这3年期间的数据,我们研究了(1)查询该系统的医疗服务提供者数量以及(2)他们查询系统的天数的快速增加是否与他们在CS处方开具方面的行为有关。我们假设,PDMP使用的这两个指标都不会与接受CS处方的患者数量或CS处方的配药数量减少相关。我们发现,这些变量中的任何一个与CS处方配药患者数量或CS处方配药数量之间均无关联。然而,我们确实发现PDMP使用量的增长与阿片类镇痛药的处方配药数量之间存在轻微的正相关关系。关于PDMPs可能会限制CS处方开具行为的担忧并无依据。

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