Table 3.
Prescribing among PDMP-registrants who queried the PDMP frequently (>1 query per 6 opioid prescriptions) or infrequently.
| Prescribing in the 6 month interval March 2012-August, 2012 | Prescribing in the 30 month interval March 2012-August, 2014 | |||||
|---|---|---|---|---|---|---|
| Prescribing metric, per prescriber, adjusted mean (95% CI)a (deaths and hospitalizations are group totals) | Prescribers with infrequent queries n = 464 |
Prescribers with frequent queries n = 463 |
p-value | Prescribers with infrequent queries n =464 |
Prescribers with frequent queries n =463 |
p-value |
| Primary Prescribing Outcomes | ||||||
| Opioid patients with an average daily MME ≥90 in the intervalb | 5.09 (4.27, 6.07) | 3.56 (2.86, 4.43) | .015 | 6.73 (5.67, 7.98) | 5.74 (4.62, 7.14) | .310 |
| % of opioid prescriptions that overlap a sedative-hypnotic prescription within 30 daysc | 12.9% (12.0, 13.9) | 11.1% (10.2, 12.1) | .016 | 13.7% (12.8, 14.6) | 12.6% (11.5, 13.7) | .122 |
| Patients with ≥ 3 opioid prescribers in any 2 mo. interval | 5.75 (5.15, 6.42) | 6.01 (5.43, 6.65) | .544 | 32.4 (29.2, 36.0) | 35.8 (32.8, 38.9) | .123 |
| Inappropriate opioid prescriptionsd | 1.50 (1.31, 1.72) | 1.37 (1.15, 1.64) | .430 | 7.02 (6.19, 7.96) | 5.93 (5.19, 6.78) | .081 |
| Secondary prescribing outcomes | ||||||
| Opioid prescriptions | 226 (209, 245) | 200 (182, 220) | .034 | 1066 (987, 1153) | 977 (885, 1079) | .135 |
| Benzodiazepine prescriptions | 70.6 (64.5, 77.2) | 67.0 (59.7, 75.2) | .452 | 348 (315, 383) | 336 (293, 385) | .694 |
| Units per opioid prescription (most often pills) | 47.1 (44.4, 50.0) | 44.8 (42.4, 47.4) | .297 | 48.3 (45.7, 51.0) | 48.5 (45.6, 51.6) | .923 |
| Patients who filled at least one opioid prescription | 90.7 (84.2, 97.7) | 100 (93.7, 108) | .053 | 296 (271, 322) | 377 (347, 410) | <.001 |
| % of patients with overlapping long-acting and short-acting opioid prescriptions within 30 d | 6.19% (5.70, 6.68) | 6.16% (5.46, 6.85) | .944 | 6.21% (5.71, 6.71) | 6.47% (5.72, 7.22) | .588 |
| Opioid prescriptions per patient with at least one opioid prescription | 1.98 (1.90, 2.06) | 1.89 (1.80, 1.99) | .132 | 3.24 (3.04, 3.44) | 2.91 (2.69, 3.15) | .027 |
| Total MME per prescriptionb | 580 (530, 634) | 502 (460, 548) | .013 | 580 (537, 626) | 529 (488, 574) | .084 |
| Total MME per patient with at least one opioid prescriptionb | 2,654 (2467, 2856) | 2,436 (2137, 2776) | .272 | 7,909 (7215, 8669) | 7,580 (6687, 8593) | .589 |
| Patients with ≥ 3 pharmacies in a 2 month interval | 2.54 (2.27, 2.84) | 3.14 (2.82, 3.49) | .004 | 15.6 (14.0, 17.5) | 20.5 (18.7, 22.6) | <.001 |
| Percent of prescribers with at least 1 opioid prescription | 99.7% (98.4, 99.96) | 99.5% (98.5, 99.9) | .305 | 99.78%e | 99.57%e | – |
| Health-Related Outcomes (n)f | ||||||
| Opioid related hospitalization | 116 | 83 | 0.024 | 612 | 475 | <0.001 |
| Opioid overdose death | 6 | 5 | 1.00 | 26 | 18 | 0.295 |
Mean adjusted rates from Poisson GEE models are presented with upper and lower confidence intervals.
Metrics that use MME exclude prescriptions that did not have complete conversion factor, quantity, or strength information (0.2% of opioid prescriptions). MME calculations exclude buprenorphine and pentazocine.
“Sedative-hypnotics” included benzodiazepines, non-benzodiazepine sedative-hypnotics, and carisoprodol
Inappropriate opioid prescriptions are those where a second prescription with the same drug name, from a different prescriber, was filled within 7 days of a first prescription that contained ≥30 pills.
Unadjusted percentages. Statistical model did not converge because values are too close to 100% for both groups.
Each event is attributed to the prescriber of the most recent opioid, benzodiazepine, or non-benzodiazepine sedative hypnotic prescription filled in the 5 months prior to the event. Some patients are counted multiple times, once for every hospitalization event. Heroin related events are excluded.