Institute for Behavioral Health, Brandeis University, Waltham, MA, USA.
Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Drug Alcohol Depend. 2019 Jun 1;199:1-9. doi: 10.1016/j.drugalcdep.2019.02.010. Epub 2019 Mar 22.
Comprehensive mandatory use laws for prescription drug monitoring programs (PDMPs) have been implemented in a number of states to help address the opioid overdose epidemic. These laws may reduce opioid-related overdose deaths by increasing prescribers' use of PDMPs and reducing high-risk prescribing behaviors.
We used state PDMP data to examine the effect of these mandates on prescriber registration, use of the PDMP, and on prescription-based measures of patient risk in three states-Kentucky, Ohio, and West Virginia-that implemented mandates between 2010 and 2015. We conducted comparative interrupted time series analyses to examine changes in outcome measures after the implementation of mandates in the mandate states compared to control states.
Mandatory use laws increased prescriber registration and utilization of the PDMP in the mandate states compared to controls. The multiple provider episode rate, rate of opioid prescribing, rate of overlapping opioid prescriptions, and rate of overlapping opioid/benzodiazepine prescriptions decreased in Kentucky and Ohio. Nevertheless, the magnitude of changes in these measures varied among mandates states.
These findings indicate that PDMP mandates have the potential to reduce risky opioid prescribing practices. Variation in the laws may explain why the effectiveness varied between states.
为了解决阿片类药物过量的流行问题,许多州都实施了综合的、强制性的处方药物监测计划(PDMP)使用法规。这些法规可能会通过增加医生对 PDMP 的使用和减少高危处方行为,从而减少与阿片类药物相关的过量死亡。
我们使用州 PDMP 数据,研究了这些法规对医生注册、PDMP 使用以及处方风险患者基于处方的衡量标准的影响,这三个州——肯塔基州、俄亥俄州和西弗吉尼亚州——在 2010 年至 2015 年期间实施了法规。我们进行了比较性的中断时间序列分析,以研究在有法规的州与对照组实施法规后,这些衡量标准的变化情况。
与对照组相比,强制性使用法规增加了有法规的州的医生注册和 PDMP 的使用。肯塔基州和俄亥俄州的多医生就诊率、阿片类药物处方率、阿片类药物重叠处方率和阿片类药物/苯二氮䓬类药物重叠处方率下降。然而,这些措施的变化幅度在不同的法规州之间有所不同。
这些发现表明,PDMP 法规有可能减少危险的阿片类药物处方行为。法规的差异可能解释了为什么在不同的州之间效果不同。