Association of the Use of a Mandatory Prescription Drug Monitoring Program With Prescribing Practices for Patients Undergoing Elective Surgery

Abstract

A mandatory PDMP query requirement was not significantly associated with the overall rate of opioid prescribing or the mean number of pills prescribed for patients undergoing general surgical procedures. In no cases was a high-risk patient identified, leading to avoidance of an opioid prescription. A PDMP can be a useful adjunct in certain settings, but this study found that it did not have the intended effect in a population undergoing elective surgical procedures. Legislative efforts to mandate PDMP use should be targeted to populations in which benefit can be demonstrated.

Impact of prescription drug monitoring program mandate on postoperative opioid prescriptions in children

“…Although statewide PDMPs do serve a purpose in reduction in opioid misuse and have been associated with decreased opioid overdoses in children [ 19 ] and a reduction in opioid-related deaths [ 23 ], their utility in surgical patients remains questionable. Our findings are in line with a similar study in adult surgical patients that did not find a change in overall opioid prescriptions following PDMP implementation [ 18 ], but we did demonstrate a decrease in the amount of opioid prescriptions for greater than 5 days’ duration. Further research is needed to determine how PDMPs can be best utilized to aid ongoing efforts in reduction of opioid use and misuse and which systems and educational interventions can further augment these efforts.…”

“…This mandate applied to any surgical patient who would be receiving a supply of opioids for more than 5 days duration [ 17 ]. A recent observational study in New Hampshire of adult postsurgical patients following institution of mandatory PDMP consultation did not show a decrease in the rate of opioid prescription [ 18 ]. However, statewide PDMPs and pain clinic legislations have been associated with decreased rates of opioid overdose in children [ 19 ].…”

Prescription drug monitoring programs, opioid abuse, and crime

“…Many states have yet to enact stringent provisions to their PDMPs, and some providers resist using the PDMP due to time constraints, learning costs, and because often times these databases are not well‐integrated into the electronic medical records of the medical practice (Grecu et al ., 2019). There have also been some drawbacks associated with PDMPs, which include additional costs to the healthcare system and compliance difficulties (Islam and McRae, 2014; Stucke et al ., 2018). Hence, the overall value of these programs is still actively debated, despite recommendations from policymakers and public health organizations urging states to adopt these provisions.…”

A Rapid Review of the Impact of Systems-Level Policies and Interventions on Population-Level Outcomes Related to the Opioid Epidemic, United States and Canada, 2014-2018

“…92,93 Six studies found that mandatory use of PDMPs, including unsolicited and proactive reporting of patient prescription histories, improved opioid-related outcomes. [94][95][96][97][98][99] ThesepositivefindingsonstrongPDMPswere notuniform:1studyfoundnosignificantassociationbetween mandatory use requirements and the number of opioid prescriptions among patients undergoing general surgical procedures 100 and another study found that strong and weak PDMPs were associated with similar changes in opioid prescription rates, the number of cumulative doses, and prescriptionlength(indays)amongMedicarebeneficiaries. 101 Studies published after our review period investigated GoodSamaritanlaws,painclinicandmarijuanaregulations, prescribing guidelines, and educational interventions.…”