Amin-Esmaeili Masoumeh, Gribble Anna, Johnson Renee M, Alinsky Rachel H, Oyedele Natasha, Parnham Taylor, Byregowda Himani, Schneider Kristin E, Park Ju Nyeong, Goddard Lindsey, Susukida Ryoko
Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University.
Maryland Department of Health (MDH), Office of Provider Engagement and Regulation (OPER).
Drug Alcohol Depend Rep. 2022 Oct 29;5:100111. doi: 10.1016/j.dadr.2022.100111. eCollection 2022 Dec.
Unsolicited reporting is the activity of analyzing Prescription Drug Monitoring Program (PDMP) data and then sending unsolicited reporting notifications (URNs) to prescribers to notify them of their outlier prescribing behavior. We aimed to describe information about prescribers who were issued URNs.
A retrospective study of Maryland's PDMP data from Jan.2018-Apr.2021. All providers who were issued ≥ one URN were included in analyses. We summarized data on types of URNs issued by provider type and years in practice using basic descriptive measures. We also performed logistic regression analysis to provide odds ratio and estimated marginal probability of issuing ≥ one URN to providers in the Maryland health care workforce in comparison with physicians as reference group.
A total of 4,446 URNs were issued to 2,750 unique providers. Odds ratio (OR) and the population estimated probability of issuing URNs were higher among nurse practitioners [OR: 1.42, 95% Confidence Interval (CI): 1.26-1.59] followed by physician assistants [OR: 1.87, 95% CI: 1.69-2.08], compared to physicians. Physicians and dentists with >10 years in practice comprised the majority of providers who were issued URNs (65.1% and 62.6%, respectively), while majority of nurse practitioners had been in practice for <10 years (75.8%).
Findings indicate a higher probability of issuing URN for Maryland's physician assistants and nurse practitioners, compared to physicians, and an overrepresentation of physicians and dentists with longer and nurse practitioners with shorter practice experience. The study suggests education programs on safer prescribing practices and management of opioids should target certain types of providers.
主动报告是指分析处方药监测计划（PDMP）数据，然后向开处方者发送主动报告通知（URN），以告知他们异常的开处方行为。我们旨在描述收到URN通知的开处方者的相关信息。
对2018年1月至2021年4月马里兰州的PDMP数据进行回顾性研究。所有收到≥1份URN的提供者都纳入分析。我们使用基本描述性指标总结了按提供者类型和执业年限发放的URN类型的数据。我们还进行了逻辑回归分析，以提供与作为参考组的医生相比向马里兰州医疗保健人员中的提供者发放≥1份URN的优势比和估计边际概率。
共向2750名不同的提供者发放了4446份URN通知。与医生相比，执业护士发放URN的优势比（OR）和总体估计概率更高[OR：1.42，95%置信区间（CI）：1.26 - 1.59]，其次是医师助理[OR：1.87，95%CI：1.69 - 2.08]。执业超过10年的医生和牙医占收到URN通知的提供者的大多数（分别为65.1%和62.6%），而大多数执业护士的执业年限<10年（75.8%）。
研究结果表明，与医生相比马里兰州的医师助理和执业护士收到URN通知的可能性更高，且执业年限较长的医生和牙医以及执业年限较短的执业护士占比过高。该研究表明，关于更安全的开处方做法和阿片类药物管理的教育计划应针对某些类型的提供者。
