TY - JOUR
T1 - Impact of unsolicited reporting notifications on providers’ prescribing behavior
T2 - An experimental study on Maryland PDMP data
AU - Amin-Esmaeili, Masoumeh
AU - Alinsky, Rachel
AU - Johnson, Renee M.
AU - Gribble, Anna
AU - Oyedele, Natasha
AU - Parnham, Taylor
AU - Goddard, Lindsey
AU - Susukida, Ryoko
N1 - Funding Information:
This research was supported by a grant from MDH to the Maryland Overdose Data Collaborative at Johns Hopkins Bloomberg School of Public Health through a Cooperative Agreement number 6NU17CE924961 . The study was exempt from IRB review because it was a secondary data analysis involving unidentifiable information and did not constitute human subject research.
Publisher Copyright:
© 2023 Elsevier B.V.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Background: Unsolicited Reporting Notifications(URNs) have been a component of Maryland's Prescription Drug Monitoring Program (PDMP) since 2016. We evaluated the effect of URNs on providers’ prescription behaviors. Methods: This is a quasi-experimental study of providers who were issued at least one URN from January 2018 to April 2021. Providers for whom URNs were not successfully delivered were designated as a comparison group. The outcome variables were average daily opioid and benzodiazepine prescriptions, average morphine milligram equivalents per patient, and proportion of overlapping opioid and benzodiazepine, either with or without muscle relaxant prescriptions. Changes were compared before versus after the issuance of a URN among the intervention and comparison groups using “Generalized Estimation Equation” and “Generalized Linear” Models. We also conducted stratified analyses by types of URN, including notifications for multiple provider episodes (MPE), overdose fatality (ODF), and dangerous drug combinations (DDC). Results: The average daily number of opioids prescriptions (3.3% decrease in the intervention group vs 22.7% increase in the comparison group, P<0.001), co-prescription of opioids and benzodiazepines either with muscle relaxants (68.0% decrease vs. 36.1% decrease, P<0.001), or without muscle relaxants (6.0% decrease vs. 16.3% increase, P<0.001), significantly reduced after the first URN regardless of the type of URN. Stratified analysis by types of URNs showed that ODF and DDC URNs had a significant effect on most of the outcomes of interest. Conclusion: The findings suggest that unsolicited reporting, especially particular types of URNs including ODF and DDC, is associated with subsequent changes in unsafe prescribing behaviors.
AB - Background: Unsolicited Reporting Notifications(URNs) have been a component of Maryland's Prescription Drug Monitoring Program (PDMP) since 2016. We evaluated the effect of URNs on providers’ prescription behaviors. Methods: This is a quasi-experimental study of providers who were issued at least one URN from January 2018 to April 2021. Providers for whom URNs were not successfully delivered were designated as a comparison group. The outcome variables were average daily opioid and benzodiazepine prescriptions, average morphine milligram equivalents per patient, and proportion of overlapping opioid and benzodiazepine, either with or without muscle relaxant prescriptions. Changes were compared before versus after the issuance of a URN among the intervention and comparison groups using “Generalized Estimation Equation” and “Generalized Linear” Models. We also conducted stratified analyses by types of URN, including notifications for multiple provider episodes (MPE), overdose fatality (ODF), and dangerous drug combinations (DDC). Results: The average daily number of opioids prescriptions (3.3% decrease in the intervention group vs 22.7% increase in the comparison group, P<0.001), co-prescription of opioids and benzodiazepines either with muscle relaxants (68.0% decrease vs. 36.1% decrease, P<0.001), or without muscle relaxants (6.0% decrease vs. 16.3% increase, P<0.001), significantly reduced after the first URN regardless of the type of URN. Stratified analysis by types of URNs showed that ODF and DDC URNs had a significant effect on most of the outcomes of interest. Conclusion: The findings suggest that unsolicited reporting, especially particular types of URNs including ODF and DDC, is associated with subsequent changes in unsafe prescribing behaviors.
KW - Inappropriate opioid prescription
KW - Opioid overdose
KW - Prescription Drug Monitoring Programs
KW - Prescription drug abuse
KW - Unsolicited reporting notification
UR - http://www.scopus.com/inward/record.url?scp=85158865506&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85158865506&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2023.109896
DO - 10.1016/j.drugalcdep.2023.109896
M3 - Article
C2 - 37163865
AN - SCOPUS:85158865506
SN - 0376-8716
VL - 248
JO - Drug and alcohol dependence
JF - Drug and alcohol dependence
M1 - 109896
ER -