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Provider Compliance With Kentucky's Prescription Drug Monitoring Program's Mandate To Query Patient Opioid History
Colleen M Carey1, Giacomo Meille2, Thomas C Buchmueller3
1Colleen M. Carey is an assistant professor in the Department of Policy Analysis and Management at Cornell University, in Ithaca, New York.
Health Affairs (Project Hope)
|March 1, 2021
Summary
Mandatory querying of prescription drug monitoring programs (PDMPs) significantly increased provider usage for opioid prescriptions. However, full compliance remained incomplete, especially for high-risk patients.
Area of Science:
- Health Policy
- Public Health
- Pharmacology
Background:
- Forty states mandate prescription drug monitoring program (PDMP) queries before controlled substance prescribing.
- Provider utilization of PDMPs, with or without mandates, is not well understood.
Purpose of the Study:
- To measure the impact of a comprehensive PDMP mandate on provider querying behavior for opioid prescriptions.
- To analyze PDMP query rates across different patient risk profiles and provider specialties.
Main Methods:
- Retrospective analysis of opioid prescriptions in Kentucky from 2010 to 2018.
- Comparison of PDMP query rates before and after the implementation of a state-wide mandate.
Main Results:
- PDMP queries increased from 12% to 56% of opioid prescriptions post-mandate.
- Query rates varied by patient risk (3% to 25%) and provider type (pain specialists 31% to 72%).
- High-compliance providers shifted prescribing away from high-risk patients, unlike low-compliance providers.
Conclusions:
- A comprehensive PDMP mandate substantially increased provider querying for opioid prescriptions.
- Incomplete compliance persists, particularly for high-risk patients, indicating a need for further interventions.
- Provider behavior and prescribing patterns to at-risk patients differ based on PDMP compliance levels.
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