An examination of opioid prescription trends and modifications in Pennsylvania after the establishment of a prescription drug monitoring program (PDMP) spanning the period of 2016 to 2020.
The Pennsylvania Department of Health's PDMP furnished the de-identified data used for a cross-sectional analysis.
The Rothman Orthopedic Institute Foundation for Opioid Research & Education utilized statistics derived from data collected across the entire state of Pennsylvania.
Prescription opioid trends following the establishment of the PDMP.
Opioid prescriptions numbered nearly two million for patients throughout the state in 2016. Nevertheless, opioid prescriptions experienced a 38% decline by the conclusion of the 2020 study period.
From Q3 2016 onwards, a steady decline in the number of opioid prescriptions was evident in every subsequent quarter, culminating in an approximate 34.17 percent decrease by the first quarter of 2020. More specifically, the first quarter of 2020 saw a decrease of over 700,000 prescriptions in comparison to the third quarter of 2016. The prevalent opioids, administered in high frequency, included oxycodone, hydrocodone, and morphine.
Even though the overall number of prescriptions issued declined in 2020, the distribution of drug types remained substantially similar to the distribution observed in 2016. Between 2016 and 2020, fentanyl and hydrocodone demonstrated the greatest decrease in usage rates.
While the overall volume of prescriptions dispensed lessened during 2020, the classification of drugs prescribed exhibited a striking similarity to the pattern observed in 2016. The period from 2016 to 2020 saw the largest decrease in the prevalence of fentanyl and hydrocodone compared to other substances.
The potential for controlled substance (CS) polypharmacy and accidental poisoning in patients can be assessed by using prescription drug monitoring programs (PDMPs).
After the Florida law obligating PDMP queries was enacted, a retrospective review, examining PDMP outcomes before and after the intervention, was carried out on a random sample of provider notes.
The West Palm Beach Veterans Affairs Health Care System's mission encompasses both inpatient and outpatient healthcare.
We reviewed a 10% random sample of progress notes, which documented PDMP outcomes, for both September-November of 2017 and the corresponding months of 2018.
Florida's 2018 legislation mandated that all new and renewed controlled substances prescriptions undergo PDMP queries.
A key aim of this study was to differentiate PDMP utilization and prescribing practices, comparing the pre- and post-legislation outcomes based on query-derived data.
The documentation of PDMP queries in progress notes experienced an increase exceeding 350 percent, escalating from 2017 to 2018. During 2017 and 2018, PDMP queries revealed a noteworthy presence of non-Veterans Affairs (VA) CS prescriptions, amounting to 306 percent (68/222) in 2017 and 208 percent (164/790) in 2018. CS prescriptions were avoided by providers in 235 percent (16 out of 68) of cases involving non-VA CS prescriptions in 2017, and this avoidance was less widespread but still evident, at 11 percent (18/164) of cases in 2018. A review of non-VA prescriptions in 2017 queries exposed overlapping or unsafe combinations in 10% (7/68) of the cases, while 14% (23/164) of queries with non-VA prescriptions in 2018 presented similar issues.
The requirement for PDMP queries boosted the total query count, yielded favorable findings, and led to overlapping controlled substance prescriptions. The introduction of the mandatory PDMP system significantly influenced how 10-15 percent of patients were prescribed opioids, with clinicians opting to discontinue existing prescriptions or avoiding the initiation of new ones.
The policy of requiring PDMP queries caused a rise in the total number of queries, confirmed findings, and overlapping controlled substance prescriptions. The PDMP mandate's effects on prescribing included avoidance and discontinuation of controlled substance (CS) initiation, impacting 10 to 15 percent of patients.
New Jersey's political leaders have stressed the requirement to lessen the pervasive opioid crisis, since opioid use disorder frequently results in addiction and, tragically, death. Molecular Biology New Jersey's Senate Bill 3, passed in 2017, instituted a significant change to opioid prescription practices for acute pain, limiting prescriptions to a five-day supply, impacting both inpatient and outpatient settings. Thus, we aimed to assess the effect of the bill's enactment on opioid pain medication use at an American College of Surgeons-verified Level I Trauma Center.
Patients receiving inpatient care from 2016 to 2018 were assessed for variations in average daily morphine milligram equivalent (MME) consumption and injury severity score (ISS), in addition to other factors. In order to assess the influence of changes in pain medication on the quality of pain management, we examined the average pain ratings.
Despite a statistically significant increase in the average ISS score (106.02 in 2018 versus 91.02 in 2016, p < 0.0001), opioid consumption decreased in 2018 without any corresponding rise in the average pain rating for individuals with an ISS of 9 or 10. In 2016, the average daily inpatient consumption of MMEs was 141.05; however, by 2018, it had decreased to 88.03, a statistically significant reduction (p < 0.0001). Zemstvo medicine Even for patients with an average Injury Severity Score (ISS) exceeding 15, there was a reduction in the total number of MMEs consumed per person in 2018 (1160 ± 140 to 594 ± 76, p < 0.0001).
Although overall opioid consumption in 2018 was lower, the quality of pain management did not suffer. By way of successful implementation, the new legislation has caused a decrease in inpatient opioid use.
Opioid consumption during 2018 was lower overall, without impacting positively the quality of pain management. The new law's deployment has produced a demonstrable decrease in the quantity of inpatient opioid use, it would appear.
Examining opioid prescribing and monitoring trends, including medication-assisted treatment approaches for opioid use disorders, within mid-Michigan's musculoskeletal patient population.
A retrospective analysis of 500 randomly selected patient charts, coded for musculoskeletal (MSK) conditions and opioid-related disorders using the 10th revision of the International Statistical Classification of Diseases (ICD-10), was conducted between January 1st and June 30th, 2019. Data collected were analyzed by comparing them to baseline data from a previous 2016 study, in order to evaluate prescribing trends.
Emergency departments and outpatient clinics.
Prescription opioid, nonopioid medications, prescription monitoring (like urine drug screens and PDMP), pain agreements, medication-assisted treatment (MAT) prescriptions, and demographic factors were all considered variables.
2019 saw 313 percent of patients receiving new or current opioid prescriptions, a considerable drop compared to 2016's 657 percent (p = 0.0001). The use of PDMP and pain agreements for opioid prescribing monitoring improved, but UDS monitoring continued to show a lack of significant increase. In 2019, MAT prescribing for patients grappling with opioid use disorder reached a substantial 314 percent rate. State-sponsored insurance demonstrated an association with a much higher probability of using prescription drug monitoring programs (PDMPs) and pain management agreements, with an odds ratio of 172 (0.97–313); on the other hand, alcohol abuse displayed a lower probability of PDMP use (OR 0.40).
Guidelines for opioid prescribing have demonstrably decreased opioid prescriptions and bolstered the utilization of opioid prescription monitoring systems. The 2019 rate of MAT prescribing was low and didn't correspond to a diminishing trend in opioid prescriptions during the public health crisis.
Opioid prescribing guidelines have proven effective in decreasing opioid prescriptions and enhancing opioid prescription monitoring systems. MAT prescriptions, while exhibiting a low number in 2019, did not mirror a projected decline in opioid prescriptions amid the public health crisis.
Patients maintained on opioid therapy are potentially at a higher risk for respiratory difficulties or death, a risk that can be lessened via prompt naloxone treatment. Patients receiving ongoing opioid analgesic therapy in primary care settings should, according to CDC guidelines, be presented with the opportunity to receive a naloxone prescription, determined by their daily oral morphine milligram equivalent dose or by concurrent benzodiazepine therapy. Although opioid overdose risk is tied to the administered dose, other patient-related factors also substantially contribute to this risk. An additional set of risk factors are incorporated into the RIOSORD index, which helps to evaluate the risk of overdose or clinically significant respiratory depression induced by opioids.
Different standards for naloxone co-prescription – CDC, VA RIOSORD, and civilian RIOSORD – were compared in terms of their frequency of application in this study.
A retrospective analysis of charts was carried out at 42 Federally Qualified Health Centers in Illinois, specifically for all CII-CIV opioid analgesic prescriptions. Patients on ongoing opioid therapy, as defined in this study, had received seven or more prescriptions for opioid analgesics (Schedule II-IV) over the one-year study period. M4205 Patients receiving opioids for non-malignant pain and meeting the criteria of ongoing opioid therapy, were considered for the study's analysis, these patients' ages ranged from 18 to 89 years.
Throughout the study period, a complete count of 41,777 controlled substance analgesic prescriptions was tallied. The individual patient charts of 651 patients were scrutinized for data. Sixty-six patients, selected from the pool, were found to meet the inclusion criteria. The statistical analysis of these data revealed that 579 percent of patients (N = 351) met the civilian RIOSORD criteria; 365 percent (N = 221) satisfied the VA RIOSORD criteria; and 228 percent (N = 138) complied with the CDC's guidelines for naloxone co-prescribing.