Colleen M. Carey is an assistant professor in the Department of Policy Analysis and Management at Cornell University, in Ithaca, New York.
Giacomo Meille is a PhD student in the Stephen M. Ross School of Business, University of Michigan, in Ann Arbor, Michigan.
Health Aff (Millwood). 2021 Mar;40(3):461-468. doi: 10.1377/hlthaff.2020.01316.
Forty states mandate that providers query their patients' prescription histories in the state's prescription drug monitoring program (PDMP) before prescribing controlled substances. However, little is known about providers' use of PDMPs, either with or without a mandate. We measured the share of opioid prescriptions with PDMP queries in Kentucky from 2010 to 2018, before and after the implementation of the first comprehensive PDMP mandate in the US. Providers queried the PDMP for 12 percent of opioid prescriptions before the mandate; after the mandate, they queried for 56 percent of prescriptions. The share of prescriptions queried was lowest for patients without recent opioid use (3 percent before the mandate, 25 percent after) and highest for pain management specialists (31 percent before, 72 percent after). Over time, high-compliance providers reduced prescribing to the riskiest patients, whereas low-compliance providers continued to prescribe to them. Although the share of prescriptions queried greatly increased after the mandate, compliance remained incomplete, including for patients with high-risk patterns of opioid use.
40 个州都要求医疗服务提供者在开具受控物质处方之前，查询本州的处方药物监测计划（PDMP）中的患者用药记录。然而，对于医疗服务提供者是否在有或没有强制要求的情况下使用 PDMP，我们知之甚少。我们测量了肯塔基州从 2010 年到 2018 年在实施美国第一个全面 PDMP 强制要求之前和之后，PDMP 对阿片类药物处方的查询比例。在强制要求之前，医疗服务提供者查询 PDMP 的阿片类药物处方占 12%；在强制要求之后，他们查询了 56%的处方。最近没有使用阿片类药物的患者的处方查询比例最低（强制要求前为 3%，强制要求后为 25%），疼痛管理专家的查询比例最高（强制要求前为 31%，强制要求后为 72%）。随着时间的推移，高合规性的提供者减少了对风险最高的患者的处方，而低合规性的提供者继续为他们开处方。尽管在强制要求之后，查询处方的比例大大增加，但合规性仍然不完整，包括对有高风险阿片类药物使用模式的患者。
