The effect of a statewide prescription drug monitoring program on opioid prescribing patterns

Rubin, Samuel J.; Wang, Judy J.; Nodoushani, Ariana; Yarlagadda, Bharat B.; Wulu, Jacqueline A.; Edwards, Heather

doi:10.1016/j.amjoto.2021.103262

Cited by 2 publications

(1 citation statement)

References 37 publications

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“…Still, patients who did not request a refill were likely prescribed more than was necessary. There exist a variety of recommendations regarding how many opioid tablets to prescribe after inguinal hernia repair surgery, ranging from 6 to 15 tablets [ 19 , 23 , 30 – 33 ]. Some of these recommendations are based on expert consensus, while others are based on patient-reported opioid use after surgery.…”

Section: Discussionmentioning

confidence: 99%

Opioid prescribing practices and patient-requested refill patterns following laparoscopic inguinal hernia repair

Gentle

Thomas

Montelione

et al. 2022

Hernia

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Purpose Excessive post-operative opioid prescribing has led to efforts to match prescriptions with patient need after surgery. We investigated opioid prescribing practices, rate of patient-requested opioid refills, and associated factors after laparoscopic inguinal hernia repair (LIHR). Methods LIHRs at a single institution from 3/2019 to 3/2021 were queried from the Abdominal Core Health Quality Collaborative for demographics, perioperative details, and patient-reported opioid usage. Opioid prescriptions at discharge and opioid refills were extracted from the medical record. Univariate and multivariable regression were used to identify factors associated with opioid refills within 30-days of surgery. Results Four hundred and ninety LIHR patients were analyzed. The median number of opioid tablets prescribed was 12 [interquartile range (IQR) 10–15], and 4% requested a refill. On univariate analysis, patients who requested refills were younger [55 years (IQR 37–61) vs. 62 years (IQR 36.8–61), p = 0.012], more likely to have undergone transabdominal preperitoneal repair (75% vs. 26.4%, p < 0.001), have a scrotal component (30% vs. 11%, p = 0.022), and have permanent tacks used (80% vs. 49.4%, p = 0.014). There was a 12% increase in the odds of opioid refill for every 1 tablet of oxycodone prescribed at discharge (95% CI for OR 1.04–1.21, p = 0.003) after controlling for age and surgery type. Patient-reported opioid use was available for 289 (59%) patients. Post-operatively, 67% of patients used ≤ 4 opioid tablets, and 87% used no more than 10 opioid tablets. Conclusion Most patients use fewer opioid tablets than prescribed. Requests for opioid refills are rare following LIHR (4%) and associated with higher opioid prescribing.

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Section: Discussionmentioning

confidence: 99%

Opioid prescribing practices and patient-requested refill patterns following laparoscopic inguinal hernia repair

Gentle

Thomas

Montelione

et al. 2022

Hernia

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Helpful, Unnecessary, or Harmful: A Systematic Review of the Effects of Prescription Drug Monitoring Program Use on Opioid Prescriptions

Smith,

Thornton,

Fenton

et al. 2023

Pharmacoepidemiology

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Prescription drug misuse is a global problem, especially in the United States (US). Clinician involvement is necessary in this crisis, and prescription drug monitoring programs (PDMPs) are a recommended tool for the prevention, recognition, and management of prescription opioid misuse. However, because of the plethora of differences between different PDMPs, research on their effects is mixed. Yet, despite varied evidence, policy on PDMP use is trending stricter and more comprehensive. We aimed to identify patterns in the research to inform clinicians and policy. Through a systematic review of four literature databases (CINAHL, Cochrane Database, Embase, and Medline/OVID), we found 56 experimental and quasi-experimental studies published between 2016 and 2023 evaluating PDMP effects on clinician behavior. To address study heterogeneity, we categorized studies by type of intervention and study outcome. The review suggests that more comprehensive PDMP legislation is associated with decreases in the number of opioid prescriptions overall and the number of risky prescriptions prescribed or dispensed. However, this review shows that much is still unknown, encourages improvements to PDMPs and policies, and suggests further research.

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The effect of a statewide prescription drug monitoring program on opioid prescribing patterns

Cited by 2 publications

References 37 publications

Opioid prescribing practices and patient-requested refill patterns following laparoscopic inguinal hernia repair

Opioid prescribing practices and patient-requested refill patterns following laparoscopic inguinal hernia repair

Helpful, Unnecessary, or Harmful: A Systematic Review of the Effects of Prescription Drug Monitoring Program Use on Opioid Prescriptions

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