Changes in opioid prescribing after implementation of mandatory registration and proactive reports within California’s prescription drug monitoring program

Details

• Alternative Title:
  Drug Alcohol Depend
• Personal Author:
  Castillo-Carniglia, Alvaro ; González-Santa Cruz, Andrés ; Cerdá, Magdalena ; Delcher, Chris ; Shev, Aaron B. ; Wintemute, Garen J. ; Henry, Stephen G.
• Description:
  Background.
  
  In 2016, California updated its prescription drug monitoring program (PDMP), adding two key features: automated proactive reports to prescribers and mandatory registration for prescribers and pharmacists. The effects of these changes on prescribing patterns have not yet been examined. We aimed to evaluate the joint effect of these two PDMP features on county-level prescribing practices in California.
  
  Methods.
  
  Using county-level quarterly data from 2012 to 2017, we estimated the absolute change associated with the implementation of these two PDMP features in seven prescribing indicators in California versus a control group comprising counties in Florida and Washington: opioid prescription rate per 1,000 residents; patients’ mean daily opioid dosage in milligrams of morphine equivalents[MME]; prescribers’ mean daily MME prescribed; prescribers’ mean number of opioid prescriptions per day; percentage of patients getting >90 MME/day; percentage of days with overlapping prescriptions for opioids and benzodiazepines; multiple opioid provider episodes per 100,000 residents.
  
  Results.
  
  Proactive reports and mandatory registration were associated with a 7.7 MME decrease in patients’ mean daily opioid dose (95%CI: −11.4, −2.9); a 1.8 decrease in the percentage of patients prescribed high-dose opioids (95%CI: −2.3, −0.9); and a 6.3 MME decrease in prescribers’ mean daily dose prescribed (95%CI: −10.0, −1.3).
  
  Conclusions.
  
  California’s implementation of these two PDMP features was associated with decreases in the total quantity of opioid MMEs prescribed, and indicators of patients prescribed high-dose opioids compared to states that had PDMP’s without these features. Rates of opioid prescribing and other high-risk prescribing patterns remained unchanged.
• Subjects:
  • Analgesics, Opioid
  • Benzodiazepines
  • California
  • Drug Prescriptions
  • Female
  • Florida
  • Humans
  • Male
  • Morphine
  • Pharmacists
  More +
• Keywords:
  • prescription drug monitoring program
  • prescribing practices
  • opioid analgesics
  • California
  • program evaluation
  • Alzheimer's disease
  • Alzheimer's disease sequencing project
  • antiviral agents
  • herpes simplex
  • human papillomavirus
  More +
• Source:
  Drug Alcohol Depend. 218:108405
• Pubmed ID:
  33234299
• Pubmed Central ID:
  PMC7750250
• Document Type:
  Journal Article
• Funding:
  K23 DA043052/DA/NIDA NIH HHSUnited States/ ; U17 CE002747/CE/NCIPC CDC HHSUnited States/
• Volume:
  218
• Download URL:
  https://stacks.cdc.gov/view/cdc/99812/cdc_99812_DS1.pdf
• File Type:
  [PDF - 348.97 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:367c2073bc0a109e558634a2d79366a05af57d39f891b9c592868c2e8e10bbb642262f4a566d3f48c3eae9a7d800e037ae80fa3aa8881cfb8464c1b5ec7cb76b