Peter W Kreiner1, Gail K Strickler2, Eduardo A Undurraga2, Maria E Torres2, Ruslan V Nikitin2, Anne Rogers3. 1. PDMP Center of Excellence, Schneider Institutes for Health Policy, Brandeis University, 415 South Street, Waltham, MA 02453-2728, United States. Electronic address: pkreiner@brandeis.edu. 2. PDMP Center of Excellence, Schneider Institutes for Health Policy, Brandeis University, 415 South Street, Waltham, MA 02453-2728, United States. 3. Maine Office of Substance Abuse, 11 State House Station, 41 Anthony Avenue, Augusta, ME 04333, United States.
Abstract
BACKGROUND: Prescription opioids are commonly overprescribed. However, validated measures of inappropriate controlled substance prescribing are lacking. This study examined associations between prescriber risk indicators developed as part of a public health surveillance project and medical board disciplinary actions against prescribers. METHODS: We compiled 12 prescriber risk indicators using data from the Maine prescription drug monitoring program (PDMP) for 2010. We used logistic regression models to assess the relative likelihood of the top 1%, 2%, 5%, and 10% of prescribers on each risk indicator having been subject to medical board disciplinary actions, those citing inappropriate prescribing, or those involving license suspension or revocation, during 2010-2014, controlling for prescriber medical specialty and gender. RESULTS: The top 1% of prescribers for number of patients, opioid prescriptions per day, and opioid dosage prescribed per day had a greater likelihood of medical board disciplinary actions citing inappropriate prescribing, relative to a matched sample of other (non-top 1%) prescribers. Of the 56 prescribers in the top 1% for opioid prescriptions per day, nine (16.1%) were sanctioned for inappropriate prescribing, compared with 11 of 224 (0.5%) in the comparison group. The top 2% of prescribers for opioid dosage per day, and average distance patients travel to prescriber, had a greater likelihood of actions involving license suspension, revocation, or denial for renewal. CONCLUSIONS: Measures derived from PDMP data may be useful in assessing levels of inappropriate prescribing of controlled substances in a population of prescribers, and in evaluating changes associated with efforts to influence prescriber behavior.
BACKGROUND: Prescription opioids are commonly overprescribed. However, validated measures of inappropriate controlled substance prescribing are lacking. This study examined associations between prescriber risk indicators developed as part of a public health surveillance project and medical board disciplinary actions against prescribers. METHODS: We compiled 12 prescriber risk indicators using data from the Maine prescription drug monitoring program (PDMP) for 2010. We used logistic regression models to assess the relative likelihood of the top 1%, 2%, 5%, and 10% of prescribers on each risk indicator having been subject to medical board disciplinary actions, those citing inappropriate prescribing, or those involving license suspension or revocation, during 2010-2014, controlling for prescriber medical specialty and gender. RESULTS: The top 1% of prescribers for number of patients, opioid prescriptions per day, and opioid dosage prescribed per day had a greater likelihood of medical board disciplinary actions citing inappropriate prescribing, relative to a matched sample of other (non-top 1%) prescribers. Of the 56 prescribers in the top 1% for opioid prescriptions per day, nine (16.1%) were sanctioned for inappropriate prescribing, compared with 11 of 224 (0.5%) in the comparison group. The top 2% of prescribers for opioid dosage per day, and average distance patients travel to prescriber, had a greater likelihood of actions involving license suspension, revocation, or denial for renewal. CONCLUSIONS: Measures derived from PDMP data may be useful in assessing levels of inappropriate prescribing of controlled substances in a population of prescribers, and in evaluating changes associated with efforts to influence prescriber behavior.
Authors: Kathryn Hawk; Gail D'Onofrio; David A Fiellin; Marek C Chawarski; Patrick G O'Connor; Patricia H Owens; Michael V Pantalon; Steven L Bernstein Journal: Acad Emerg Med Date: 2017-12-26 Impact factor: 3.451
Authors: Gerald Cochran; Jennifer Brown; Ziji Yu; Stacey Frede; M Aryana Bryan; Andrew Ferguson; Nadia Bayyari; Brooke Taylor; Margie E Snyder; Elizabeth Charron; Omolola A Adeoye-Olatunde; Udi E Ghitza; T Winhusen Journal: Drug Alcohol Depend Date: 2021-09-24 Impact factor: 4.492