Dataset Information

Association of prescription drug monitoring program laws with bedridden and missed work days.

ABSTRACT:

Objective

To examine the relationship between optional and must-use prescription drug monitoring programs (PDMPs) and markers of disability.

Data sources

Nationwide data from the National Health Interview Survey for 2006-2015.

Study design

Generalized difference-in-difference models with state-specific time trends were used to assess the relationship between PDMPs and two outcomes: missed days of work and bedridden days.

Data collection/extraction methods

All respondents above the age of 18 years with complete data on key measures were included. A subpopulation of respondents who had a recent surgery or injury was identified.

Principal findings

We found an increase of 3.3 and 5.9 bedridden days associated with optional and must-use PDMPs, respectively, for respondents reporting a recent injury or surgery (p-values <0.05; unadjusted population average 12.2 bedridden days). Increases in days of missed work were not statistically significant.

Conclusions

Implementation of PDMPs was associated with negative unintended consequences in the injury/surgery subpopulation. The association between bedridden days and PDMPs suggests a gap between clinical trials showing equivalence of opioids and nonopioids for pain treatment and real-world results. As increasingly tighter opioid restrictions proliferate, evidence-based strategies to address pain without opioids in the acute pain population likely need to be more widely disseminated.

SUBMITTER: Wetzel M

PROVIDER: S-EPMC8586471 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association of prescription drug monitoring program laws with bedridden and missed work days.

Wetzel Martha M Yarbrough Courtney R CR von Esenwein Silke A SA Hockenberry Jason M JM

Health services research 20210819 6

<h4>Objective</h4>To examine the relationship between optional and must-use prescription drug monitoring programs (PDMPs) and markers of disability.<h4>Data sources</h4>Nationwide data from the National Health Interview Survey for 2006-2015.<h4>Study design</h4>Generalized difference-in-difference models with state-specific time trends were used to assess the relationship between PDMPs and two outcomes: missed days of work and bedridden days.<h4>Data collection/extraction methods</h4>All respond ...[more]

PMID: 34409600

Similar Datasets

Project description:ObjectiveThe US CDC identified prescription drug monitoring programs (PDMPs) as a tool to address the contemporary opioid crisis, but few studies have investigated PDMP usability and effectiveness from the users' perspective. Even fewer have considered how practices differ across medical domains. In this study, we aimed to address these gaps, soliciting perspectives on PDMPs from providers contending with the opioid crisis: physicians working in emergency departments (EDs) and pain management clinics. We aimed to provide practical design recommendations to improve PDMP workflow integration, as well as controlled substance history retrieval, interpretation, and decision support.MethodsWe conducted 16 in-depth semi-structured interviews with practicing emergency and pain physicians regarding their procedures, problems, and proposed solutions surrounding their use of CURES, California's PDMP. We investigated design problems in CURES by combining users' feedback with our usability inspection, drawing upon an extensive body of design literature. Then, we generated alternatives using design methods.ResultsWe found CURES's design did not accommodate the unique information needs of different medical domains. Further, clinicians had trouble accessing CURES and retrieving patients' controlled substance histories, mainly due to usability problems that could be addressed with little technical adjustment. Additionally, CURES rendered patient histories in large, cluttered tables, devoid of overview or context, making interpretation difficult and precarious. Lastly, our interviewees had rarely noticed or used advanced features, such as decision support.Discussion and conclusionUsability barriers inhibited adoption and effective use. We provide practical recommendations for improving opioid control by way of improving PDMP design, based on interviewees' suggestions and research-based design principles. Our findings have implications for other disciplines, including surgery and primary care.

Project description:ObjectiveClinical review of a prescription drug monitoring program (PDMP) is considered a valuable tool for opioid prescribing risk mitigation; however, PDMP use is often low, even in states with mandatory registration and use policies. The objective was to evaluate the impact of an academic detailing (AD) outreach intervention on PDMP use among primary care prescribers.MethodsAD intervention was delivered to primary care based controlled substance prescribers (N = 87) and their associated PDMP delegates (n = 42) by a clinical pharmacist as 1 component of a large-scale, statewide initiative to improve opioid prescribing safety. Prescriber PDMP use behavior was assessed by prescriber self-report and analysis of objective 2016-2018 PDMP data regarding the number of monthly report requests. We compared means between pre- and postintervention using a paired t test and plotted the monthly average reports over time to assess the trend of mean reports over time. Generalized linear mixed model with a negative binomial distribution was used to assess the difference in the trend and magnitude of the combined count of reports for the entire sample and prescriber subsets that were segmented on the basis of the adoption status of PDMP.ResultsThe monthly mean of reports by combined prescribers and delegates significantly increased after the AD intervention (mean 28.1 pre vs. 53.0 post; P < 0.001), with the increase in delegate reports (mean 17.1 pre vs. 60.0 post; P < 0.001) driving the overall increase. Reports were requested 40.4 times more often than in the preintervention period (P < 0.001). Patterns of pre- to postchanges in mean monthly report requests differed by baseline PDMP adoption status.ConclusionThe AD intervention was transformative in facilitating practice change to use delegates to run reports. Visits with both prescribers and delegates, including hands-on PDMP training and registration assistance, can be viewed as beneficial for practice facilitation.

Dataset Information

Association of prescription drug monitoring program laws with bedridden and missed work days.

Objective

Data sources

Study design

Data collection/extraction methods

Principal findings

Conclusions

Publications

Association of prescription drug monitoring program laws with bedridden and missed work days.

Similar Datasets

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