Effects of a Prescription Monitoring Program on Opioid Prescribing, Dispensing

The use of prescription monitoring programs may not be associated with reductions in opioid prescribing and dispensing.

The use of prescription monitoring programs (PMPs) may not be associated with reductions in opioid prescribing and dispensing, according to a systematic review published in the Journal of Pain.  

PMPs aim to promote appropriate use of prescription opioid medications by housing and monitoring data on healthcare providers’ prescribing practices and providing this information to prescribers and dispensers. In this systematic review, only studies that were designed to assess the impact of PMP implementation on outcomes, were included.

A total of 24 studies were included (75% conducted in the United States), encompassing data from 1993 to 2014. Although the evidence did not support an association between PMPs and reductions in opioid prescribing and dispensing, there was limited but inconsistent evidence indicating that PMPs were associated with reductions in the use of multiple providers as well as in the prescribing and dispensing of schedule II opioid medications (including hydrocodone and oxycodone). By decreasing schedule II opioid availability, PMPs may represent a valuable intervention to prevent the diversion of high-potency opioids. In the included studies, covariate adjustment in analyses was often inadequate, as was the timing of PMP measurement and outcome.

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“Potentially inappropriate prescribing and nonmedical use of prescription opioids were not investigated commonly in the PMP literature and represent an area for future research. Future studies should broaden their geographic scope to countries other than the United States, employ primary data collection or draw on more diverse datasets, seek to synthesize the evidence around PMPs and other monitored drugs, make use of more recent data, and consider the impact of other arms of opioid strategies on opioid-related outcomes,” concluded the study authors.

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Wilson MN, Hayden JA, Rhodes E, Robinson A, Asbridge M. Effectiveness of prescription monitoring programs in reducing opioid prescribing, dispensing, and use outcomes: a systematic review [published online May 3, 2019].  J Pain. doi: 10.1016/j.jpain.2019.04.007