DMD Candidate, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA; MPH Candidate, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Associate Fellow, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
DMD Candidate, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Jul;132(1):26-31. doi: 10.1016/j.oooo.2021.01.015. Epub 2021 Jan 16.
To curb opioid overprescription and diversion, 49 states have implemented mandatory prescription drug monitoring programs (PDMPs). This study aims to examine the changes in analgesic prescription patterns associated with mandatory PDMP usage by oral and maxillofacial surgeons.
This retrospective observational cohort study analyzed analgesic prescriptions after third molar surgeries from the University of Pennsylvania from July 2016 to December 2019. Because Pennsylvania mandated PDMP usage on January 1, 2017, we analyzed prescriptions 6 months prior to and for each 6-month interval after implementation.
Prescriptions after 13,430 procedures on 6437 patients across 7 6-month periods were analyzed. Patients in all study periods had an average age of 40 years and there was a slight majority of females. After PDMP implementation, patients who received analgesics had an 80% lower odds of receiving an opioid option after adjusting for age, sex, and procedural severity. When an opioid was prescribed, the mean pills per script decreased from 20.18 to 10.96 1 year after PDMP implementation.
Mandatory PDMP usage was associated with decreased odds of a patient receiving an opioid analgesic and with a decrease in mean opioid pills per script. PDMPs may be helpful in reducing opioid prescriptions by oral and maxillofacial surgeons after third molar surgery.
为了遏制阿片类药物的过度处方和滥用，49 个州已经实施了强制性的处方药物监测计划（PDMP）。本研究旨在检查与口腔颌面外科医生使用强制性 PDMP 相关的阿片类药物处方模式的变化。
本回顾性观察性队列研究分析了宾夕法尼亚大学 2016 年 7 月至 2019 年 12 月期间进行的第三磨牙手术后的镇痛处方。由于宾夕法尼亚州于 2017 年 1 月开始强制使用 PDMP，我们分析了实施前 6 个月和实施后每 6 个月的处方。
分析了 7 个 6 个月期间在 6437 名患者的 13430 例手术中的处方。所有研究期间的患者平均年龄为 40 岁，女性略占多数。在实施 PDMP 后，调整年龄、性别和手术严重程度后，接受镇痛剂的患者接受阿片类药物选择的可能性降低了 80%。当开出处方药时，在实施 PDMP 1 年后，每张处方的平均药丸数从 20.18 粒减少到 10.96 粒。
强制性 PDMP 使用与患者接受阿片类镇痛药的可能性降低以及每张处方的平均阿片类药物药丸数量减少有关。PDMP 可能有助于减少口腔颌面外科医生在第三磨牙手术后的阿片类药物处方。
