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High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry
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Comparing Changes in Controlled Substance Prescribing Trends by Provider Type.

Amy L Meadows1, Justin C Strickland2, Shiraz Qalbani3

  • 1Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, Kentucky.

The American Journal on Addictions
|October 11, 2019
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This summary is machine-generated.

Prescription Drug Monitoring Programs (PDMPs) impact controlled substance prescribing differently across provider types. Advanced Practice Registered Nurses (APRNs) increased prescriptions, while physicians and dentists decreased opioid prescribing.

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Area of Science:

  • Public Health
  • Pharmacology
  • Health Services Research

Background:

  • Prescription Drug Monitoring Programs (PDMPs) are widely adopted to curb controlled substance (CS) misuse.
  • Limited research exists on how PDMPs influence prescribing behaviors across different healthcare provider types.

Purpose of the Study:

  • To analyze changes in controlled substance (CS) prescribing patterns by provider type (physicians, APRNs, dentists) after mandatory PDMP use.
  • To compare prescribing trends for Schedule II and Schedule III-IV medications among different provider groups.

Main Methods:

  • Utilized aggregated yearly data from the Kentucky All Schedule Prescription Electronic Reporting System (KASPER) from 2011 to 2017.
  • Analyzed 64,578,307 total prescriptions and 3,982,130,994 doses, stratified by provider type and medication schedule.

Main Results:

  • Physicians and dentists reduced Schedule II opioid prescriptions (27-32%) and stimulants (69-80% for dentists).
  • APRNs significantly increased Schedule II opioid (121-204%) and stimulant (334-360%) prescriptions.
  • Similar, though less pronounced, trends were observed for Schedule III-IV medications.

Conclusions:

  • Mandatory PDMP use led to divergent prescribing trends among provider types.
  • APRNs showed increased CS prescribing, contrasting with reductions by physicians and dentists, despite similar regulatory requirements.