Physician Attitudes Toward the Rhode Island Duplicate Prescription Law and Self-Reported Prescribing Practices for Schedule Ii Medications

Anness, Bridgit A.; Willey, Cynthia; Taubman, Albert H.

doi:10.3109/10601339509019621

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…Response rates to mailed and online surveys of clinicians are notoriously low (cf. [18–21]). Monetary incentives provide only marginal benefit in clinician response rates [22,23] and were not supported by the study budget.…”

Section: Methodsmentioning

confidence: 99%

How Does Use of a Prescription Monitoring Program Change Medical Practice?

Green¹,

Mann

Bowman

et al. 2012

Pain Med

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Section: Methodsmentioning

confidence: 99%

How Does Use of a Prescription Monitoring Program Change Medical Practice?

Green¹,

Mann

Bowman

et al. 2012

Pain Med

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“…A total of 4 pain management programs (n = 4; 6.3%) were found, which consist of a multidisciplinary pain care approach that is used for analgesic medications, encouraging the use of nonopioid analgesics such as antidepressants and anticonvulsants (23,(29)(30)(31). Several United States policies (n = 3; 4.7%) were also identified including the following: a case study from Oregon of the National Governor's Association State Policy Academy on Reducing Prescription Drug Abuse; the Texas Triplicate Prescription Law; The Florida Pill Mill Law, which essentially involves mandatory PMP and duplicate prescriptions; medication schedule; and formulary restrictions (32)(33)(34).…”

Section: Types Of Interventionsmentioning

confidence: 99%

“…Studies showed that multiple copy prescription program (MCPPs) were associated with a decrease in the prescription of Schedule II medications; this decrease was due to inconvenience rather than an increased awareness of appropriate prescribing (34). These patterns suggest that less potent drugs are substituted for Schedule II analgesics in MCPP states (36).…”

Section: Types Of Designs N (%)mentioning

confidence: 99%

A Systematic Review of Interventions and Programs Targeting Appropriate Prescribing of Opioids

Moride

2019

Pain Phys

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Background: Canada and the United States have the highest levels of prescription opioid consumption in the world. In an attempt to curb the opioid epidemic, a variety of interventions have been implemented. Thus far, evidence regarding their effectiveness has not been consolidated. Objectives: The objectives of this study were to: 1) identify interventions that target opioid prescribing; 2) assess and compare the effectiveness of interventions on opioid prescription and related harms; 3) determine the methodological quality of evaluation studies. Study Design: The study involved a systematic review of the literature including bibliographical databases and gray literature sources. Setting: Systematic review including bibliographical databases and gray literature sources. Methods: We searched MEDLINE, Embase, and LILACS databases from January 1, 2005 to September 23, 2016 for any intervention that targeted the prescription of opioids. We also examined websites of relevant organizations and scanned bibliographies of included articles and reviews for additional references. The target population was that of all health care providers (HCPs) or users of opioids with no restriction on indication. Endpoints were those related to process (implementation), outcomes (effectiveness), or impact. Sources were screened independently by 2 reviewers using pre-defined eligibility criteria. Synthesis of findings was qualitative; no pooling of results was conducted. Results: Literature search yielded 12,278 unique sources. Of these, 142 were retained. During full-text review, 75 were further excluded. Searches of the gray literature and bibliographies yielded 49 additional sources. Thus, a total of 95 distinct interventions were identified. Over half consisted of prescription monitoring programs (PMPs) and mainly targeted HCPs. Evaluation studies addressed mainly opioid prescription rate (30.6%), opioid use (19.4%), or doctor shopping or diversion (9.7%). Fewer studies considered overdose death (9.7%), abuse (9.7%), misuse (4.2%), or diversion (5.6%). Study designs consisted of cross-sectional surveys (23.3%), pre-post intervention (26.7%), or time series without a comparison group (13.3%), which limit the robustness of the evidence. Although PMPs and policies have been associated with a reduction in opioid prescription, their impact on appropriateness of use according to clinical guidelines and restriction of access to patients in need is inconsistent. Continuing medical education (CME) and pain management programs were found effective in improving chronic pain management, but studies were conducted in specific settings. The impact of interventions on abuse and overdose-death is conflicting. Limitations: Due to the very large number of publications and programs found, it was difficult to compare interventions owing to the heterogeneity of the programs and to the methodologies of evaluation studies. No assessment of publication bias was done in the review. Conclusions: Evidence of effectiveness of interventions targeting the prescription of opioids is scarce in the literature. Although PMPs have been associated with a reduction in the overall prescription rates of Schedule II opioids, their impact on the appropriateness of use taking into consideration benefits, misuse, legal and illegal use remains elusive. Our review suggests that existing interventions have not addressed all determinants of inappropriate opioid prescribing and usage. A well-described theoretical framework would be the backdrop against which targeted interventions or policies may be developed. Key words: Opioid, prescription, abuse, misuse, diversion, interventions, prescription monitoring programs

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