Health affairs scholar · 2025
Prescription drug monitoring programs and perioperative opioid prescribing and adverse events.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Constantin Joanne, Waljee Jennifer, Nguyen Thuy, Bohnert Amy, Nuliyalu Usha, Brummett Chad M, Chua Kao-Ping
Аннотация
INTRODUCTION: Most states mandate clinicians to review prescription drug monitoring program (PDMP) databases before prescribing opioids, but the association with perioperative outcomes is unknown.
METHODS: We analyzed 2016-2019 Medicare claims for patients ≥65 undergoing surgery in 21 states that enacted PDMP use mandates in 2017-2018 vs states without mandates during 2016-2019. Procedure-level, difference-in-differences models adjusted for patient demographics, prior opioid use, mental health, prior substance use disorders, comorbidities, surgeon specialty, and procedure type. Outcomes included discharge opioid prescriptions, days supplied, total and daily morphine milligram equivalents, high-risk prescribing (≥7-day supply or opioid-benzodiazepine overlap), and 30-day post-discharge adverse events (overdose, emergency department visit, hospitalization, or death).
RESULTS: Among 597 455 procedures for 462 290 patients (mean age 73.3 years; 54.5% female), mandates were not associated with changes in opioid prescribing, high-risk prescribing, or adverse events (difference-in-differences estimate: -0.03% points, 95% CI: -1.0, 0.9). Findings were consistent among patients with prior substance use or in states with stringent mandates.
CONCLUSION: PDMP use mandates were not associated with changes in perioperative opioid prescribing or post-surgical adverse events, suggesting that policymakers should consider pairing mandates with evidence-based, procedure-specific prescribing guidelines.
METHODS: We analyzed 2016-2019 Medicare claims for patients ≥65 undergoing surgery in 21 states that enacted PDMP use mandates in 2017-2018 vs states without mandates during 2016-2019. Procedure-level, difference-in-differences models adjusted for patient demographics, prior opioid use, mental health, prior substance use disorders, comorbidities, surgeon specialty, and procedure type. Outcomes included discharge opioid prescriptions, days supplied, total and daily morphine milligram equivalents, high-risk prescribing (≥7-day supply or opioid-benzodiazepine overlap), and 30-day post-discharge adverse events (overdose, emergency department visit, hospitalization, or death).
RESULTS: Among 597 455 procedures for 462 290 patients (mean age 73.3 years; 54.5% female), mandates were not associated with changes in opioid prescribing, high-risk prescribing, or adverse events (difference-in-differences estimate: -0.03% points, 95% CI: -1.0, 0.9). Findings were consistent among patients with prior substance use or in states with stringent mandates.
CONCLUSION: PDMP use mandates were not associated with changes in perioperative opioid prescribing or post-surgical adverse events, suggesting that policymakers should consider pairing mandates with evidence-based, procedure-specific prescribing guidelines.