Table 2.
Studies of Prescription Drug Monitoring Program (PDMP) Impact by Domain of Opioid-Related Outcome Measure
| Article | State(s)/Years Examined | Outcome measure | Design/Methods | Findings | Evidence for PDMP Benefit |
|---|---|---|---|---|---|
| Domain 1: Opioid Prescribing Behavior | |||||
| Paulozzi, 2011a [3] | PDMP and non-PDMP states; 1995–2005 | Mean MME rates | Crude mean MMEb rates and their standard errors for PDMP and non-PDMP states were calculated by year and across 1999–2005 timespan. | According to results of a regression analysis, the presence of a PDMP was not a significant predictor of MME rates. | No |
| Brady, 2014 [2] | PDMP and non-PDMP states; 1999–2008 | Opioids dispensed per quarter for each state from 1999 to 2008 | Multivariable linear regression model with generalized estimating equations assessed the effect of state PDMPs on per-capita dispensing of MMEs. | Overall, implementation of state PDMPs up to 2008 did not show significant impact on per-capita opioids dispensed. Examined state-by-state, authors found PDMP implementation associated with per capita MME decline in 9 states, increase in 8 states, and no effect in 14 states. | No |
| Rasubala, 2015 [21] | New York; 2012–2014 | Frequency and volume of opioid prescriptions by dentists in a dental urgent care center | Cross-sectional survey of a dental urgent care center 3 months before and 6 months after implementation of a PDMP | Total prescribed opioids decreased 78% by dentists in a dental urgent care center after a mandatory PDMP was implemented. | Yes |
| Ringwalt, 2015 [11] | North Carolina; 2009–2011 | Number of filled prescriptions for opioids | Examined associations between total number of providers who used the PDMP, mean number of days providers queried the system, and filled opioid prescriptions. | Strong positive association between increasing use of PDMP and opioid analgesic prescriptions over time. | No |
| Rutkow, 2015 [25] | Florida; 2010–2012 | Opioid volume, per transaction, MME prescribed, MME per transaction, days’ supply per transaction, prescriptions dispensed. | Comparative interrupted time-series analysis to assess the effect of PDMP and ‘pill mill law’ implementation on a closed cohort of prescribers, retail pharmacies, and patients. | Jointly the PDMP and ‘pill mill’ policies were associated with reductions in total opioid volume, mean MME per transaction, and total number of opioid prescriptions dispensed. | Yes |
| Domain 2: Opioid Diversion and Supply | |||||
| Reisman, 2009a [12] | PDMP and non-PDMP states; 1997–2003 | State prescription opioid shipments (ARCOS)b | Compared state prescription opioid shipments in 14 states with PDMPs (intervention group) and 36 states without PDMPs (control group). | States with PDMPs received fewer oxycodone shipments that non-PDMP states; opioid shipments in all states continued to rise. | Yes |
| Surratt, 2014 [26] | Florida; 2009–2012 | Quarterly prescription opioid diversion rates | Changes in prescription opioid diversion rates identified using quarterly law enforcement data after implementation of PDMP and ‘pill mill’ laws assessed using hierarchical linear models. | Significant decline in oxycodone diversion; nonsignificant (p = 0.08) decline in hydrocodone diversion; no decline in fentanyl, hydromorphone, or tramadol. | Yes |
| Domain 3: Opioid Misuse | |||||
| Reifler, 2012a [15] | PDMP and non-PDMP states; 2003–2009 | Cases of intentional exposure to opioids (RADARS)b | Repeated measures negative binomial regression was applied to quarterly case data to estimate opioid misuse trends. PMP presence was modeled as a time-varying covariate for each state. | Results suggest PDMPs are associated with a mitigation of increasing opioid misuse over time in both the general population as well as within the population seeking treatment at Opioid Treatment Programs. | Yes |
| Domain 4: Opioid-related Morbidity/Mortality | |||||
| Reisman, 2009a [12] | PDMP vs. non-PDMP states; 1997–2003 | Inpatient prescription opioid treatment admissions per year | Inpatient admissions for prescription opioid abuse (TEDS)b in 14 states with PDMPs (intervention group) and 36 states without PDMPs (control group). | PDMP states reported a smaller increase in opioid treatment admissions per year (p[=0.06). Patients receiving inpatient drug treatment in PDMP states were less likely to have been admitted for prescription opioids. | Yes |
| Paulozzi, 2011a [3] | PDMP and non-PDMP states; 1999–2005 | Rates of drug overdose and opioid-related mortality by state | Regression analysis using mortality data by state and year, crude mean mortality and standard error for PDMP and non-PDMP states. | Mortality rates did not differ by a statistically significant margin between PDMP and non-PDMP states. | No |
| Reifler, 2012a [15] | PDMP and non-PDMP states; 2003–2009 | Opioid treatment admissions | Repeated measures negative binomial regression applied to quarterly surveillance data from 2003 to mid-2009 to estimate opioid abuse trends. PDMP presence was modeled as a time-varying covariate for each state. | States with PDMPs appeared to experience smaller increases in drug abuse over time. | Yes |
| Li, 2014 [16] | PDMP and non-PDMP states; 1999–2008 | Drug overdose mortality data for state-quarters | Multivariate negative binomial regression modeling examined drug overdose mortality for states with and without PDMPs during 1999–2008. | PDMP states experienced higher drug overdose mortality overall; PDMP impact on mortality varied by state. | No |
| Delcher, 2015 [17] | Florida; 2003–2012 | Monthly counts of oxycodone-caused deaths | Time-series, quasi-experimental research design with ARIMAb statistical models examined monthly counts of oxycodone-caused deaths using a binary variable (pre/post-implementation). | Implementation of Florida’s Prescription Drug Monitoring Program was associated with a significant decline in oxycodone-caused mortality | Yes |
| Maughan, 2015 [27] | 11 Multi-state metropolitan areas; 2004–2011 | Rates of emergency department visits involving opioid analgesics | Using retrospective data (DAWN)b, generalized estimating equations assessed PDMP implementation and opioid-related morbidity. | PDMP implementation was not associated with change in rates of ED visits involving opioid analgesics. | No |
aArticle findings addressed more than one domain of opioid-related outcome
b MME Morphine Milligram Equivalents, ARCOS Automation of Reports and Consolidated Orders Systems, RADARS Researched, Abuse, Diversion and Addiction-Related Surveillance system, TEDS Treatment Episode Data Sets, ARIMA Autoregressive Integrated Moving Average models, DAWN Drug Abuse Warning Network