Health services research · 2021
Association of prescription drug monitoring program laws with bedridden and missed work days.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Wetzel Martha, Yarbrough Courtney R, von Esenwein Silke A, Hockenberry Jason M
Аннотация
OBJECTIVE: To examine the relationship between optional and must-use prescription drug monitoring programs (PDMPs) and markers of disability.
DATA SOURCES: Nationwide data from the National Health Interview Survey for 2006-2015.
STUDY DESIGN: Generalized difference-in-difference models with state-specific time trends were used to assess the relationship between PDMPs and two outcomes: missed days of work and bedridden days.
DATA COLLECTION/EXTRACTION METHODS: All respondents above the age of 18 years with complete data on key measures were included. A subpopulation of respondents who had a recent surgery or injury was identified.
PRINCIPAL FINDINGS: We found an increase of 3.3 and 5.9 bedridden days associated with optional and must-use PDMPs, respectively, for respondents reporting a recent injury or surgery (p-values <0.05; unadjusted population average 12.2 bedridden days). Increases in days of missed work were not statistically significant.
CONCLUSIONS: Implementation of PDMPs was associated with negative unintended consequences in the injury/surgery subpopulation. The association between bedridden days and PDMPs suggests a gap between clinical trials showing equivalence of opioids and nonopioids for pain treatment and real-world results. As increasingly tighter opioid restrictions proliferate, evidence-based strategies to address pain without opioids in the acute pain population likely need to be more widely disseminated.
DATA SOURCES: Nationwide data from the National Health Interview Survey for 2006-2015.
STUDY DESIGN: Generalized difference-in-difference models with state-specific time trends were used to assess the relationship between PDMPs and two outcomes: missed days of work and bedridden days.
DATA COLLECTION/EXTRACTION METHODS: All respondents above the age of 18 years with complete data on key measures were included. A subpopulation of respondents who had a recent surgery or injury was identified.
PRINCIPAL FINDINGS: We found an increase of 3.3 and 5.9 bedridden days associated with optional and must-use PDMPs, respectively, for respondents reporting a recent injury or surgery (p-values <0.05; unadjusted population average 12.2 bedridden days). Increases in days of missed work were not statistically significant.
CONCLUSIONS: Implementation of PDMPs was associated with negative unintended consequences in the injury/surgery subpopulation. The association between bedridden days and PDMPs suggests a gap between clinical trials showing equivalence of opioids and nonopioids for pain treatment and real-world results. As increasingly tighter opioid restrictions proliferate, evidence-based strategies to address pain without opioids in the acute pain population likely need to be more widely disseminated.