Query mandates in prescription drug monitoring programs reduce opioid use among commercially insured patients with cancer
| Autor: | Tham Thi Le, Linda Simoni-Wastila, Aida Kuzucan, Anna Dizik, Sean P. Fleming |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Population Pharmacology (nursing) Pharmacy Newly diagnosed Neoplasms medicine Humans Practice Patterns Physicians' Prescription Drug Monitoring Program education Retrospective Studies Pharmacology education.field_of_study business.industry Opioid use Cancer Retrospective cohort study Opioid-Related Disorders medicine.disease Analgesics Opioid Opioid Emergency medicine Cohort Prescription Drug Monitoring Programs business medicine.drug |
| Zdroj: | Journal of the American Pharmacists Association. 62:363-369 |
| ISSN: | 1544-3191 |
| DOI: | 10.1016/j.japh.2021.06.013 |
| Popis: | Prescription drug monitoring programs (PDMPs) have been shown to reduce opioid use in the general and noncancer populations. However, evidence of PDMP impacts on patients with cancer remains limited.The aim of the study was to examine the impact of PDMP mandates on individual-level opioid use among patients with cancer.This is a retrospective cohort study of patients with newly diagnosed cancer aged 18-65 years in the IQVIA PharMetrics Plus database (IQVIA Inc; nationally representative data of the U.S. commercially insured population in 49 states) between 2013 and 2015. The primary exposure was PDMP rigor (ranked from highest to lowest rigor): provider query + registration, query only, registration only, and unexposed. The study outcomes included (1) prevalent use among all individuals; and among opioid users (2) total days supplied, (3) daily morphine equivalent dose (MED), and (4) cumulative MED.Of the eligible cohort (n=28,353), 37.5% (10,656) received opioids after a cancer diagnosis. The individuals exposed to these mandates were as follows: query + registration: 3899 (13.8%); query only: 3459 (12.2%); registration only: 2764 (9.7%); and no mandates: 18,231 (64.3%). The PDMP mandates had no effect on prevalent opioid use. Compared with unexposed patients, those subject to query mandates-alone or with registration mandates-experienced 12 fewer opioid days supplied and a lower mean cumulative MED (-662 mg and -702 mg, respectively), P0.01. Registration-only mandates were associated with 21 days more (P0.01) total days supplied and lower daily MED (1.1 mg; P0.05) but had no statistically significant effect on cumulative MED (-46 mg, P0.05).Query mandates are a stronger PDMP tool than registration mandates in reducing opioid days supplied and cumulative MED. Initiatives should target PDMP mandates toward intended patient groups to reduce high-risk opioid use without compromising adequate pain treatment. |
| Databáze: | OpenAIRE |
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