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管制药品电子处方对阿片类药物处方的影响:来自纽约I-STOP项目的证据

Impact of Electronic Prescribing of Controlled Substances on Opioid Prescribing: Evidence From I-STOP Program in New York.

作者信息

Pylypchuk Yuriy, Parasrampuria Sonal, Smiley Carmen, Searcy Talisha

机构信息

U.S. Department of Health and Human Services, Washington, DC, USA.

Johns Hopkins University, Baltimore, MD, USA.

出版信息

Med Care Res Rev. 2022 Feb;79(1):114-124. doi: 10.1177/1077558721994994. Epub 2021 Mar 11.

Abstract

New York's Internet System for Tracking Over-Prescribing (I-STOP) Act, requires prescribers in the state to electronically prescribe controlled substances (EPCS). We examine the effects of this mandate on prescribing patterns of opioids for Medicare Part D beneficiaries. Using 2014-2017 CMS Medicare Part D Prescriber Data, we apply a lagged dependent variable regression approach to identify the impact of I-STOP on the prescription of opioids. In the first year of implementation, the number of opioid prescriptions per prescriber decreased by 5.7 per year. The policy had a larger effect on the prescription of short-acting opioids and on prescribers prescribing medication for predominantly younger beneficiaries. Overall, I-STOP resulted in a reduction in the number of beneficiaries being prescribed opioids and in the number of opioid claims in the state of New York, suggesting positive implications for other states intending to curtail opioid overprescribing and misuse through the use of EPCS.

摘要

纽约的《互联网过量处方追踪系统(I-STOP)法案》要求该州的开处方者以电子方式开具管制药品(EPCS)。我们研究了这项规定对医疗保险D部分受益人阿片类药物处方模式的影响。利用2014 - 2017年医疗保险和医疗补助服务中心(CMS)医疗保险D部分开处方者数据,我们采用滞后因变量回归方法来确定I-STOP对阿片类药物处方的影响。在实施的第一年,每位开处方者的阿片类药物处方数量每年减少5.7张。该政策对短效阿片类药物的处方以及主要为较年轻受益人开处方的开处方者有更大影响。总体而言,I-STOP导致纽约州开具阿片类药物的受益人数以及阿片类药物报销申请数量减少,这表明对其他有意通过使用EPCS来减少阿片类药物过量处方和滥用的州具有积极意义。

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