Association of state-level prescription drug monitoring program implementation with opioid prescribing transitions in primary care in Australia.

Autor: Xia T; Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia., Picco L; Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia., Buchbinder R; Musculoskeletal Health and Sustainable Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Haas R; Musculoskeletal Health and Sustainable Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Nielsen S; Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.
Jazyk: angličtina
Zdroj: British journal of clinical pharmacology [Br J Clin Pharmacol] 2024 Apr; Vol. 90 (4), pp. 1162-1172. Date of Electronic Publication: 2024 Feb 02.
DOI: 10.1111/bcp.15996
Abstrakt: Aims: This study aimed to evaluate whether voluntary and mandatory prescription drug monitoring program (PDMP) use in Victoria, Australia, had an impact on prescribing behaviour, focusing on individual patients' prescribed opioid doses and transition to prescribing of nonmonitored medications.
Methods: This was a retrospective cross-sectional study using routinely collected primary healthcare data. A 90-day moving average prescribed opioid dose in oral morphine equivalents was used to estimate opioid dosage. A Markov transition matrix was used to describe how patients prescribed medications transitioned between opioid dose groups and other nonopioid treatment options during 3 transition periods: transition between 2 control periods prior to PDMP implementation (T1 to T2); during the voluntary PDMP implementation (T2 to T3); and during mandatory PDMP implementation (T3 to T4).
Results: Among patients prescribed opioids in our study, we noted an increased probability of transitioning to not being prescribed opioids during the mandatory PDMP period (T3 to T4). This increase was attributed mainly to the ceasing of low-dose opioid prescribing. Membership in an opioid dose group remained relatively stable for most patients who were prescribed high opioid doses. For those who were only prescribed nonmonitored medications initially, the probability of being prescribed opioids increased during the mandatory PDMP when compared to other transition periods.
Conclusion: The introduction of PDMP mandates appeared to have an impact on the prescribing for patients who were prescribed low-dose opioids, while its impact on individuals prescribed higher opioid doses was comparatively limited.
(© 2024 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.)
Databáze: MEDLINE
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