Yuhua Bao (
Katherine Wen is a PhD student in the Department of Policy Analysis and Management, Cornell University, in Ithaca, New York.
Health Aff (Millwood). 2018 Oct;37(10):1596-1604. doi: 10.1377/hlthaff.2018.0512.
Policies and practices have proliferated to optimize prescribers' use of their states' prescription drug monitoring programs, which are statewide databases of controlled substances dispensed at retail pharmacies. Our study assessed the effectiveness of three such policies: comprehensive legislative mandates to use the program, laws that allow prescribers to delegate its use to office staff, and state participation in interstate data sharing. Our analysis of information from a large commercial insurance database indicated that comprehensive use mandates implemented during 2011-15 were associated with a 6-9 percent reduction in opioid prescriptions with high risk for misuse and overdose. We also found delegate laws to be associated with reductions of a similar magnitude for selected outcomes. In general, the effects of all three policies strengthened over time, especially beginning in the second year after implementation. Our findings support comprehensive use mandates and delegate laws to optimize prescribers' use of drug monitoring programs, but the results will need updates in the context of evolving state opioid policies-including the increasing integration of drug monitoring data with electronic health records.
政策和实践如雨后春笋般涌现，旨在优化处方医生对其所在州的处方药物监测计划的使用，该计划是全州范围内零售药店分发的受控物质数据库。我们的研究评估了三种此类政策的有效性：全面的立法授权使用该计划、允许处方医生将其使用委托给办公室工作人员的法律，以及州参与州际数据共享。我们对来自大型商业保险数据库的信息进行分析后发现，2011-2015 年期间实施的全面使用授权与阿片类药物处方的减少有关，这些处方具有较高的误用和过量风险。我们还发现，对于某些特定结果，委托法律也与类似幅度的减少有关。一般来说，所有三种政策的效果随着时间的推移而增强，尤其是在实施后的第二年开始。我们的研究结果支持全面使用授权和委托法律来优化处方医生对药物监测计划的使用，但在不断变化的州级阿片类药物政策背景下（包括将药物监测数据与电子健康记录越来越多地整合在一起），这些结果需要更新。
