Impact of a prescription drug monitoring program use mandate on potentially problematic patterns of opioid analgesic prescriptions in New York City

Marcus A. Bachhuber, Ellenie Tuazon, Michelle L. Nolan, Hillary V. Kunins, Denise Paone

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: To evaluate New York State's mandate that prescribers query the prescription drug monitoring program (PDMP) prior to prescribing Schedule II-IV medications. Methods: We conducted an interrupted time series analysis of opioid analgesic prescriptions dispensed to adult New York City (NYC) residents using data from New York State's PDMP. Our main outcomes were the rate of (a) greater than or equal to five prescriber episodes, (b) greater than or equal to five prescriber and greater than or equal to five pharmacy episodes, and (c) paying for prescriptions with both cash and insurance, per quarter, per 100 000 NYC residents. We defined three periods: (a) the baseline period (January 2011 to July 2012), (b) the anticipatory period (September 2012 to July 2013) after mandate law enactment but before mandate implementation, and (c) the postmandate period (September 2013 to December 2015). For each outcome, we used autoregressive linear regression models to account for correlation in outcomes over time. Results: At the end of the postmandate period, the rate of greater than or equal to five prescriber episodes was 58% lower than expected (absolute difference: −17.2 per 100 000 NYC residents; 95% CI, −31.2 to −3.1), the rate of greater than or equal to five prescriber and greater than or equal to five pharmacy episodes was 88% lower than expected (absolute difference: −8.6; 95% CI, −11.0 to −6.3), and the rate of cash and insurance payment episodes was 50% lower than expected (absolute difference: −145.4; 95% CI, −279.4 to −11.6). Conclusions: While outcomes were relatively rare, New York State's PDMP mandate was associated with significant decreases in rates of potentially problematic patterns of opioid analgesic prescriptions.

Original languageEnglish (US)
JournalPharmacoepidemiology and Drug Safety
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Prescription Drugs
Drug Monitoring
Opioid Analgesics
Prescriptions
Insurance
Linear Models
Appointments and Schedules

Keywords

  • analgesics
  • health policy
  • opioid
  • pharmacoepidemiology
  • prescription drug diversion
  • prescription drug misuse
  • prescription drug monitoring programs

ASJC Scopus subject areas

  • Epidemiology
  • Pharmacology (medical)

Cite this

Impact of a prescription drug monitoring program use mandate on potentially problematic patterns of opioid analgesic prescriptions in New York City. / Bachhuber, Marcus A.; Tuazon, Ellenie; Nolan, Michelle L.; Kunins, Hillary V.; Paone, Denise.

In: Pharmacoepidemiology and Drug Safety, 01.01.2019.

Research output: Contribution to journalArticle

@article{3541e926835c41cba7d9674600966f1c,
title = "Impact of a prescription drug monitoring program use mandate on potentially problematic patterns of opioid analgesic prescriptions in New York City",
abstract = "Purpose: To evaluate New York State's mandate that prescribers query the prescription drug monitoring program (PDMP) prior to prescribing Schedule II-IV medications. Methods: We conducted an interrupted time series analysis of opioid analgesic prescriptions dispensed to adult New York City (NYC) residents using data from New York State's PDMP. Our main outcomes were the rate of (a) greater than or equal to five prescriber episodes, (b) greater than or equal to five prescriber and greater than or equal to five pharmacy episodes, and (c) paying for prescriptions with both cash and insurance, per quarter, per 100 000 NYC residents. We defined three periods: (a) the baseline period (January 2011 to July 2012), (b) the anticipatory period (September 2012 to July 2013) after mandate law enactment but before mandate implementation, and (c) the postmandate period (September 2013 to December 2015). For each outcome, we used autoregressive linear regression models to account for correlation in outcomes over time. Results: At the end of the postmandate period, the rate of greater than or equal to five prescriber episodes was 58{\%} lower than expected (absolute difference: −17.2 per 100 000 NYC residents; 95{\%} CI, −31.2 to −3.1), the rate of greater than or equal to five prescriber and greater than or equal to five pharmacy episodes was 88{\%} lower than expected (absolute difference: −8.6; 95{\%} CI, −11.0 to −6.3), and the rate of cash and insurance payment episodes was 50{\%} lower than expected (absolute difference: −145.4; 95{\%} CI, −279.4 to −11.6). Conclusions: While outcomes were relatively rare, New York State's PDMP mandate was associated with significant decreases in rates of potentially problematic patterns of opioid analgesic prescriptions.",
keywords = "analgesics, health policy, opioid, pharmacoepidemiology, prescription drug diversion, prescription drug misuse, prescription drug monitoring programs",
author = "Bachhuber, {Marcus A.} and Ellenie Tuazon and Nolan, {Michelle L.} and Kunins, {Hillary V.} and Denise Paone",
year = "2019",
month = "1",
day = "1",
doi = "10.1002/pds.4766",
language = "English (US)",
journal = "Pharmacoepidemiology and Drug Safety",
issn = "1053-8569",
publisher = "John Wiley and Sons Ltd",

}

TY - JOUR

T1 - Impact of a prescription drug monitoring program use mandate on potentially problematic patterns of opioid analgesic prescriptions in New York City

AU - Bachhuber, Marcus A.

AU - Tuazon, Ellenie

AU - Nolan, Michelle L.

AU - Kunins, Hillary V.

AU - Paone, Denise

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: To evaluate New York State's mandate that prescribers query the prescription drug monitoring program (PDMP) prior to prescribing Schedule II-IV medications. Methods: We conducted an interrupted time series analysis of opioid analgesic prescriptions dispensed to adult New York City (NYC) residents using data from New York State's PDMP. Our main outcomes were the rate of (a) greater than or equal to five prescriber episodes, (b) greater than or equal to five prescriber and greater than or equal to five pharmacy episodes, and (c) paying for prescriptions with both cash and insurance, per quarter, per 100 000 NYC residents. We defined three periods: (a) the baseline period (January 2011 to July 2012), (b) the anticipatory period (September 2012 to July 2013) after mandate law enactment but before mandate implementation, and (c) the postmandate period (September 2013 to December 2015). For each outcome, we used autoregressive linear regression models to account for correlation in outcomes over time. Results: At the end of the postmandate period, the rate of greater than or equal to five prescriber episodes was 58% lower than expected (absolute difference: −17.2 per 100 000 NYC residents; 95% CI, −31.2 to −3.1), the rate of greater than or equal to five prescriber and greater than or equal to five pharmacy episodes was 88% lower than expected (absolute difference: −8.6; 95% CI, −11.0 to −6.3), and the rate of cash and insurance payment episodes was 50% lower than expected (absolute difference: −145.4; 95% CI, −279.4 to −11.6). Conclusions: While outcomes were relatively rare, New York State's PDMP mandate was associated with significant decreases in rates of potentially problematic patterns of opioid analgesic prescriptions.

AB - Purpose: To evaluate New York State's mandate that prescribers query the prescription drug monitoring program (PDMP) prior to prescribing Schedule II-IV medications. Methods: We conducted an interrupted time series analysis of opioid analgesic prescriptions dispensed to adult New York City (NYC) residents using data from New York State's PDMP. Our main outcomes were the rate of (a) greater than or equal to five prescriber episodes, (b) greater than or equal to five prescriber and greater than or equal to five pharmacy episodes, and (c) paying for prescriptions with both cash and insurance, per quarter, per 100 000 NYC residents. We defined three periods: (a) the baseline period (January 2011 to July 2012), (b) the anticipatory period (September 2012 to July 2013) after mandate law enactment but before mandate implementation, and (c) the postmandate period (September 2013 to December 2015). For each outcome, we used autoregressive linear regression models to account for correlation in outcomes over time. Results: At the end of the postmandate period, the rate of greater than or equal to five prescriber episodes was 58% lower than expected (absolute difference: −17.2 per 100 000 NYC residents; 95% CI, −31.2 to −3.1), the rate of greater than or equal to five prescriber and greater than or equal to five pharmacy episodes was 88% lower than expected (absolute difference: −8.6; 95% CI, −11.0 to −6.3), and the rate of cash and insurance payment episodes was 50% lower than expected (absolute difference: −145.4; 95% CI, −279.4 to −11.6). Conclusions: While outcomes were relatively rare, New York State's PDMP mandate was associated with significant decreases in rates of potentially problematic patterns of opioid analgesic prescriptions.

KW - analgesics

KW - health policy

KW - opioid

KW - pharmacoepidemiology

KW - prescription drug diversion

KW - prescription drug misuse

KW - prescription drug monitoring programs

UR - http://www.scopus.com/inward/record.url?scp=85063571712&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85063571712&partnerID=8YFLogxK

U2 - 10.1002/pds.4766

DO - 10.1002/pds.4766

M3 - Article

C2 - 30920062

AN - SCOPUS:85063571712

JO - Pharmacoepidemiology and Drug Safety

JF - Pharmacoepidemiology and Drug Safety

SN - 1053-8569

ER -