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Table 2 Studies of Prescription Drug Monitoring Program (PDMP) Impact by Domain of Opioid-Related Outcome Measure

From: Evaluating the impact of prescription drug monitoring program implementation: a scoping review

Article State(s)/Years Examined Outcome measure Design/Methods Findings Evidence for PDMP Benefit
Domain 1: Opioid Prescribing Behavior
 Paulozzi, 2011a [3] PDMP and non-PDMP states; 1995–2005 Mean MME rates Crude mean MMEb rates and their standard errors for PDMP and non-PDMP states were calculated by year and across 1999–2005 timespan. According to results of a regression analysis, the presence of a PDMP was not a significant predictor of MME rates. No
 Brady, 2014 [2] PDMP and non-PDMP states; 1999–2008 Opioids dispensed per quarter for each state from 1999 to 2008 Multivariable linear regression model with generalized estimating equations assessed the effect of state PDMPs on per-capita dispensing of MMEs. Overall, implementation of state PDMPs up to 2008 did not show significant impact on per-capita opioids dispensed. Examined state-by-state, authors found PDMP implementation associated with per capita MME decline in 9 states, increase in 8 states, and no effect in 14 states. No
 Rasubala, 2015 [21] New York; 2012–2014 Frequency and volume of opioid prescriptions by dentists in a dental urgent care center Cross-sectional survey of a dental urgent care center 3 months before and 6 months after implementation of a PDMP Total prescribed opioids decreased 78% by dentists in a dental urgent care center after a mandatory PDMP was implemented. Yes
 Ringwalt, 2015 [11] North Carolina; 2009–2011 Number of filled prescriptions for opioids Examined associations between total number of providers who used the PDMP, mean number of days providers queried the system, and filled opioid prescriptions. Strong positive association between increasing use of PDMP and opioid analgesic prescriptions over time. No
 Rutkow, 2015 [25] Florida; 2010–2012 Opioid volume, per transaction, MME prescribed, MME per transaction, days’ supply per transaction, prescriptions dispensed. Comparative interrupted time-series analysis to assess the effect of PDMP and ‘pill mill law’ implementation on a closed cohort of prescribers, retail pharmacies, and patients. Jointly the PDMP and ‘pill mill’ policies were associated with reductions in total opioid volume, mean MME per transaction, and total number of opioid prescriptions dispensed. Yes
Domain 2: Opioid Diversion and Supply
 Reisman, 2009a [12] PDMP and non-PDMP states; 1997–2003 State prescription opioid shipments (ARCOS)b Compared state prescription opioid shipments in 14 states with PDMPs (intervention group) and 36 states without PDMPs (control group). States with PDMPs received fewer oxycodone shipments that non-PDMP states; opioid shipments in all states continued to rise. Yes
 Surratt, 2014 [26] Florida; 2009–2012 Quarterly prescription opioid diversion rates Changes in prescription opioid diversion rates identified using quarterly law enforcement data after implementation of PDMP and ‘pill mill’ laws assessed using hierarchical linear models. Significant decline in oxycodone diversion; nonsignificant (p = 0.08) decline in hydrocodone diversion; no decline in fentanyl, hydromorphone, or tramadol. Yes
Domain 3: Opioid Misuse
 Reifler, 2012a [15] PDMP and non-PDMP states; 2003–2009 Cases of intentional exposure to opioids (RADARS)b Repeated measures negative binomial regression was applied to quarterly case data to estimate opioid misuse trends. PMP presence was modeled as a time-varying covariate for each state. Results suggest PDMPs are associated with a mitigation of increasing opioid misuse over time in both the general population as well as within the population seeking treatment at Opioid Treatment Programs. Yes
Domain 4: Opioid-related Morbidity/Mortality
 Reisman, 2009a [12] PDMP vs. non-PDMP states; 1997–2003 Inpatient prescription opioid treatment admissions per year Inpatient admissions for prescription opioid abuse (TEDS)b in 14 states with PDMPs (intervention group) and 36 states without PDMPs (control group). PDMP states reported a smaller increase in opioid treatment admissions per year (p[=0.06). Patients receiving inpatient drug treatment in PDMP states were less likely to have been admitted for prescription opioids. Yes
 Paulozzi, 2011a [3] PDMP and non-PDMP states; 1999–2005 Rates of drug overdose and opioid-related mortality by state Regression analysis using mortality data by state and year, crude mean mortality and standard error for PDMP and non-PDMP states. Mortality rates did not differ by a statistically significant margin between PDMP and non-PDMP states. No
 Reifler, 2012a [15] PDMP and non-PDMP states; 2003–2009 Opioid treatment admissions Repeated measures negative binomial regression applied to quarterly surveillance data from 2003 to mid-2009 to estimate opioid abuse trends. PDMP presence was modeled as a time-varying covariate for each state. States with PDMPs appeared to experience smaller increases in drug abuse over time. Yes
 Li, 2014 [16] PDMP and non-PDMP states; 1999–2008 Drug overdose mortality data for state-quarters Multivariate negative binomial regression modeling examined drug overdose mortality for states with and without PDMPs during 1999–2008. PDMP states experienced higher drug overdose mortality overall; PDMP impact on mortality varied by state. No
 Delcher, 2015 [17] Florida; 2003–2012 Monthly counts of oxycodone-caused deaths Time-series, quasi-experimental research design with ARIMAb statistical models examined monthly counts of oxycodone-caused deaths using a binary variable (pre/post-implementation). Implementation of Florida’s Prescription Drug Monitoring Program was associated with a significant decline in oxycodone-caused mortality Yes
 Maughan, 2015 [27] 11 Multi-state metropolitan areas; 2004–2011 Rates of emergency department visits involving opioid analgesics Using retrospective data (DAWN)b, generalized estimating equations assessed PDMP implementation and opioid-related morbidity. PDMP implementation was not associated with change in rates of ED visits involving opioid analgesics. No
  1. aArticle findings addressed more than one domain of opioid-related outcome
  2. b MME Morphine Milligram Equivalents, ARCOS Automation of Reports and Consolidated Orders Systems, RADARS Researched, Abuse, Diversion and Addiction-Related Surveillance system, TEDS Treatment Episode Data Sets, ARIMA Autoregressive Integrated Moving Average models, DAWN Drug Abuse Warning Network