Brandon C Maughan1, Marcus A Bachhuber2, Nandita Mitra3, Joanna L Starrels4. 1. Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: bmaughan@gmail.com. 2. Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: marcus.bachhuber@gmail.com. 3. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. Electronic address: nanditam@mail.med.upenn.edu. 4. Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA. Electronic address: jostarre@montefiore.org.
Abstract
OBJECTIVE: To determine the association between prescription drug monitoring program (PDMP) implementation and emergency department (ED) visits involving opioid analgesics. METHODS: Rates of ED visits involving opioid analgesics per 100,000 residents were estimated from the Drug Abuse Warning Network dataset for 11 geographically diverse metropolitan areas in the United States on a quarterly basis from 2004 to 2011. Generalized estimating equations assessed whether implementation of a prescriber-accessible PDMP was associated with a difference in ED visits involving opioid analgesics. Models were adjusted for calendar quarter, metropolitan area, metropolitan area-specific linear time trends, and unemployment rate. RESULTS: Rates of ED visits involving opioid analgesics increased in all metropolitan areas. PDMP implementation was not associated with a difference in ED visits involving opioid analgesics (mean difference of 0.8 visits [95% CI: -3.7 to 5.2] per 100,000 residents per quarter). CONCLUSIONS: During 2004-2011, PDMP implementation was not associated with a change in opioid-related morbidity, as measured by emergency department visits involving opioid analgesics. Urgent investigation is needed to determine the optimal PDMP structure and capabilities to improve opioid analgesic safety. Published by Elsevier Ireland Ltd.
OBJECTIVE: To determine the association between prescription drug monitoring program (PDMP) implementation and emergency department (ED) visits involving opioid analgesics. METHODS: Rates of ED visits involving opioid analgesics per 100,000 residents were estimated from the Drug Abuse Warning Network dataset for 11 geographically diverse metropolitan areas in the United States on a quarterly basis from 2004 to 2011. Generalized estimating equations assessed whether implementation of a prescriber-accessible PDMP was associated with a difference in ED visits involving opioid analgesics. Models were adjusted for calendar quarter, metropolitan area, metropolitan area-specific linear time trends, and unemployment rate. RESULTS: Rates of ED visits involving opioid analgesics increased in all metropolitan areas. PDMP implementation was not associated with a difference in ED visits involving opioid analgesics (mean difference of 0.8 visits [95% CI: -3.7 to 5.2] per 100,000 residents per quarter). CONCLUSIONS: During 2004-2011, PDMP implementation was not associated with a change in opioid-related morbidity, as measured by emergency department visits involving opioid analgesics. Urgent investigation is needed to determine the optimal PDMP structure and capabilities to improve opioid analgesic safety. Published by Elsevier Ireland Ltd.
Entities:
Keywords:
Emergency departments; Opioids; Prescription drug abuse; Prescription drug monitoring programs
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