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The Effects of North Carolina’s Prescription Drug Monitoring Program on the Prescribing Behaviors of the State’s Providers

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Abstract

State-level prescription drug monitoring programs (PDMPs) show promise as a key strategy to respond to the epidemic of the misuse and abuse of controlled substances (CS), particularly opioid analgesics, in the United States. Undocumented concerns have been expressed that these PDMPs may have a “chilling effect” on providers’ willingness to prescribe these substances to their patients. Using data from North Carolina’s PDMP for the 3-year period from 2009 through 2011, we examined whether rapid increases in (1) the number of providers who queried the system, and (2) the number of days on which they queried it, would be related to their prescribing practices in regards to CS. We hypothesized that neither marker of PDMP utilization would be associated with a decrease in either patients receiving CS prescriptions or CS prescriptions filled. We found no association between either of these variables and the number of patients who filled prescriptions for CS or the number of prescriptions for CS filled. However, we did find a slight positive relationship between the growth in the utilization of the PDMP and the number of prescriptions filled for opioid analgesics. Concerns that PDMPs may constrain prescribing behavior with regards to CS are not supported.

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References

  • Brennan, F., Carr, D. B., & Cousins, M. (2007). Pain management: A fundamental human right. Anesthesia and Analgesia, 105, 205–221.

    Article  PubMed  Google Scholar 

  • CDC. (2013). Policy impact: Prescription painkiller overdoses. Retrieved from http://www.cdc.gov/homeandrecreationalsafety/rxbrief/

  • Centers for Disease Control (CDC). (2011). Vital signs: Overdoses of prescription opioid pain relievers—United States, 1999–2008 [Vital Signs No. 60(43)] (pp. 1487–1492). Atlanta, GA: Centers for Disease Control. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm

  • Fass, J. A., & Hardigan, P. C. (2011). Attitudes of Florida pharmacists toward implementing a state prescription drug monitoring program for controlled substances. Journal of Managed Care Pharmacy, 17(6), 430–438.

    PubMed  Google Scholar 

  • Feldman, L., Williams, K. S., Coates, J., & Knox, M. (2011). Awareness and utilization of a prescription monitoring program among physicians. Journal of Pain and Palliative Care Pharmacotherapy, 25(4), 313–317.

    Article  PubMed  Google Scholar 

  • Fishman, S. M., Papazian, J. S., Gonzalez, S., Riches, P. S., & Gilson, A. (2004). Regulating opioid prescribing through prescription monitoring programs: Balancing drug diversion and treatment of pain. Pain Medicine, 5(3), 309–324.

    Article  PubMed  Google Scholar 

  • Garcia, A. M. (2013). State laws regulating prescribing of controlled substances: Balancing the public health problems of chronic pain and prescription painkiller abuse and overdose. The Journal of Law, Medicine & Ethics, 41(s1), 42–45.

    Google Scholar 

  • Hernandez, S. H., & Nelson, L. S. (2010). Prescription drug abuse: Insight into the epidemic. Clinical Pharmacology and Therapeutics, 88(3), 307–317.

    Article  CAS  PubMed  Google Scholar 

  • Institute of Medicine (IOM). (2011). Relieving pain in America: A blueprint for transforming prevention, care, education, and research. Washington, DC: The National Academies Press.

    Google Scholar 

  • Joranson, D. E., Carrow, G. M., Ryan, K. M., Schaefer, L., Gilson, A. M., Good, P.,… & Dahl, J. L. (2002). Pain management and prescription monitoring. Journal of Pain and Symptom Management, 23(3), 231–238.

  • National Alliance for Model State Drug Laws (NAMSDL). (March, 2013a). Prescription drug abuse, addiction, and diversion: Overview of state legislative and policy initiatives. Part 1: State prescription drug monitoring programs (PMPS). http://www.iowa.gov/odcp/docs/Rx%20Mon%20Programs%20NAMSDL%20March%202013.pdf

  • NAMSDL. (July, 2013b). Compilation of state prescription monitoring program maps. http://www.namsdl.org/library/13D46B1B-1372-636C-DD8A80A2928024DF/

  • National Center for Health Statistics. Bridged-race population estimates 1990–2012. Public-use data file, CDC WONDER online database. http://wonder.cdc.gov/

  • North Carolina Health Professions Data System. Annual profiles: 2009–2011 health professions tables. Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill. http://www.shepscenter.unc.edu/hp/index.html

  • North Carolina Legislation. NC § 90-113.71(a). http://www.ncleg.net/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_90/Article_5E.html

  • Paulozzi, L. J., Kilbourne, E. M., & Desai, H. A. (2011). Prescription drug monitoring programs and death rates from drug overdose. Pain Medicine, 12(5), 747–754.

    Article  PubMed  Google Scholar 

  • Perrone, J., & Nelson, L. S. (2012). Medication reconciliation for controlled substances—An “ideal” prescription-drug monitoring program. New England Journal of Medicine, 366(25), 2341–2343.

    Article  CAS  PubMed  Google Scholar 

  • Poisoning Overdose Factsheet. (January, 2013). North Carolina Division of Public Health: NC Injury and Violence Prevention Branch. http://injuryfreenc.ncdhhs.gov/About/PoisoningOverdoseFactSheet2013.pdf

  • Reifler, L. M., Droz, D., Bailey, J. E., Schnoll, S. H., Fant, R., Dart, R. C., & Bucher Bartelson, B. (2012). Do prescription monitoring programs impact state trends in opioid abuse/misuse? Pain Medicine, 13(3), 434–442.

    Article  PubMed  Google Scholar 

  • Reisman, R. M., Shenoy, P. J., Atherly, A. J., & Flowers, C. R. (2009). Prescription opioid usage and abuse relationships: An evaluation of state prescription drug monitoring program efficacy. Substance Abuse: Research and Treatment., 3, 41–51.

    Google Scholar 

  • Simeone, R., & Holland, L. (2006). An Evaluation of Prescription Drug Monitoring Programs. Simeone Associates, Inc., No. 2005PMBXK189, September 1, 2006. http://www.simeoneassociates.com/simeone3.pdf

  • Simoni-Wastila, G. E. L. (2011). Prescription monitoring programs: Striking the balance between medical use and diversion. Journal of Addictions Nursing, 22(1–2), 77–82.

    Google Scholar 

  • Substance Abuse and Mental Health Services Administration. (2011). Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings [No. HHS Publication No. (SMA) 11-4658]. Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from http://oas.samhsa.gov/NSDUH/2k10NSDUH/2k10Results.htm#2.16

  • Turk, D. C., Brody, M. C., & Okifuji, E. A. (1994). Physicians’ attitudes and practices regarding the long-term prescribing of opioids for non-cancer pain. Pain, 59(2), 201–208.

    Article  CAS  PubMed  Google Scholar 

  • Twillman, R. (2006). (324/995): Impact of prescription monitoring programs on prescription patterns and indicators of opioid abuse. The Journal of Pain, 7(4), S6.

    Article  Google Scholar 

  • Wang, J., & Christo, P. J. (2009). The influence of prescription monitoring programs on chronic pain management. Pain Physician, 12(3), 507–515.

    PubMed  Google Scholar 

  • Worley, J. (2012). Prescription Drug Monitoring Programs, a response to doctor shopping: Purpose, effectiveness, and directions for future research”. Issues in Mental Health Nursing, 33(5), 319–328.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC, USA

    Chris Ringwalt, Mariana Garrettson & Apostolos Alexandridis

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  1. Chris Ringwalt
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  2. Mariana Garrettson
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  3. Apostolos Alexandridis
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Correspondence to Chris Ringwalt.

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Ringwalt, C., Garrettson, M. & Alexandridis, A. The Effects of North Carolina’s Prescription Drug Monitoring Program on the Prescribing Behaviors of the State’s Providers. J Primary Prevent 36, 131–137 (2015). https://doi.org/10.1007/s10935-014-0381-0

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  • DOI: https://doi.org/10.1007/s10935-014-0381-0

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