A Novel Approach to PDMP Reporting: Adapting Opioid Quality Measures to PDMP Data

Area of Science:

• Health Services Research
• Public Health
• Pharmacovigilance

Background:

• The SUPPORT Act mandated the development of Prescription Drug Monitoring Programs (PDMPs) for reporting opioid quality measures.
• Health plans use claims data to assess opioid quality measures, but PDMP data offers a state-level performance view.

Purpose of the Study:

• To map, test, and adapt four opioid quality measures from health plan claims data to PDMP data.
• To evaluate the feasibility of using PDMP data for state-level opioid quality assessment.

Main Methods:

• Utilized Maryland PDMP data and claims data from Maryland Medicaid beneficiaries.
• Adapted and mapped four specific opioid quality measures (Concurrent Use of Opioids and Benzodiazepines, Opioid Overutilization, Opioid Overutilization in Patients with Cancer, and Use of Opioids from Multiple Providers in Persons Without Cancer) from claims to PDMP data.

Main Results:

• Measure rates derived from PDMP data closely aligned with those from claims data.
• Specific aligned rates included: Concurrent Opioid and Benzodiazepine Use (14.49% vs. 15.31%), Opioid Overutilization (12.44% vs. 13.54%), Opioid Overutilization in Patients with Cancer (0.01% vs. 0.40%), and Use of Opioids from Multiple Providers in Persons Without Cancer (0.12% vs. 3.03%).

Conclusions:

• This novel adaptation facilitates data sharing for opioid quality reporting between PDMPs and stakeholders.
• Replication in other states can support quality improvement initiatives and inform policy interventions to combat the drug abuse epidemic.
• Quantifying outcomes using these adapted measures supports a learning healthcare system and the Quintuple Aim.