Background: The opioid epidemic is a major public health crisis in the United States. Legislators have enacted various strategies to combat this crisis, including the implementation of statewide prescription drug monitoring programs (PDMP). These PDMPs are electronic databases that collect and analyze patient prescription data on controlled substances allowing physicians to review prior prescriptions before prescribing. Objective: To determine opioid prescribing patterns after implementation of a statewide PDMP in Pennsylvania. Methods: After IRB approval, PDMP data was obtained from the Pennsylvania Department of Health. Data obtained included: drug name, days supplied, refill count, and partially filled prescriptions. The study timeline was 3 years, from first quarter 2017 through first quarter 2020.Results: Over the three years post implementation of a PDMP, Pennsylvania saw a 33% decrease in overall quantity of opioid pills prescribed (677,194 absolute), a 9% decrease in partially filled prescriptions (5,821 absolute), and an 18% decrease in the authorized refill (525 absolute). There also was a larger rate of decrease in prescriptions for more than seven days compared to prescriptions for less than seven days (43% vs 27%). However, the rate of decrease in opioid pills prescribed lessened from 14% in the first two years post implementation, to 10% from in the third year. The decrease in opioids partially filled for the first two years averaged 14% per year, while it increased by 23% in the third year. There also was an 8% average decrease in the rate of refills for opioids prescribed for the two years post implementation, while it was only 3% in the third year. Conclusion: There was a 33% decrease in overall quantity of opioid pills prescribed in the three years after the implementation of a PDMP. The first two years after implementation saw the largest decreases in prescribing habits, which slowed in the third year. More data is needed to show the long-term effects of implementing a statewide PDMP.
Background: The opioid epidemic has hit all corners of the United States but has disproportionately affected geographical areas to varying extents over the last thirty years. Rural areas have had higher rates of opioid prescribing than urban areas. However, urban counties have higher rates of opioid overdose deaths than rural counties. This study aims to outline the trends in opioid prescribing between rural and urban counties in the state of Pennsylvania since the implementation of a statewide prescription drug monitoring program (PDMP).Methods: Data pertaining to opioid prescribing habits as listed below were obtained from the Pennsylvania Department of Health who administers the PDMP in Pennsylvania. Study data that were of interest and provided by the PDMP were: Drug name, quantity of prescriptions, average daily morphine milligram equivalents (MME), and days supplied. Urban and Rural categorizations were provided by The Center for Rural Pennsylvania, a legislative agency of the Pennsylvania General Assembly. The timeline for this study analyses began from Q1 2017 through Q1 2020. T-tests were used to compare the county informationResults: Opioid prescriptions from 2017 to 2020 decreased on average by 35% (SD= 0.13) in rural counties and 33% (SD= 0.10) in urban counties (P= 0.114). Change in average daily MME was 0.13 (SD=0.06) in the rural group and 0.14 (SD=0.03, p=0.229). Days supplied per prescription showed no significant changes between rural and urban counties with regards to; less than 3 days, 4-7 days, 8-21 days, and 31+ days. A significant decrease was seen in the 22–30-day subgroup between the rural (0.36 SD=0.08) and urban counties (0.31 SD=0.04 p=0.003).Conclusion: No significant changes were seen in the decline of opioid prescribing habits between rural and urban counties in Pennsylvania from 2017 to 2020. This compounds on similar state-specific studies showing no significant difference in the rate of decline between rural and urban counties.
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