Trends in Opioid Prescribing Following Statewide PDMP Implementation: The Pennsylvania Experience

Abstract

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.