The effectiveness of prescription drug monitoring programs at reducing opioid-related harms and consequences: a systematic review.

Humans Opioid-Related Disorders / prevention & control Prescription Drug Monitoring Programs Program Evaluation Randomized Controlled Trials as Topic
Consequences Harms Opioids Prescription drug monitoring programs

Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
01 Nov 2019
Historique:
received: 09 04 2019
accepted: 15 10 2019
entrez: 3 11 2019
pubmed: 5 11 2019
medline: 28 1 2020
Statut: epublish

Résumé

In order to address the opioid crisis in North America, many regions have adopted preventative strategies, such as prescription drug monitoring programs (PDMPs). PDMPs aim to increase patient safety by certifying that opioids are prescribed in appropriate quantities. We aimed to synthesize the literature on changes in opioid-related harms and consequences, an important measure of PDMP effectiveness. We completed a systematic review. We conducted a narrative synthesis of opioid-related harms and consequences from PDMP implementation. Outcomes were grouped into categories by theme: opioid dependence, opioid-related care outcomes, opioid-related adverse events, and opioid-related legal and crime outcomes. We included a total of 22 studies (49 PDMPs) in our review. Two studies reported on illicit and problematic use but found no significant associations with PDMP status. Eight studies examined the association between PDMP status and opioid-related care outcomes, of which two found that treatment admissions for prescriptions opioids were lower in states with PDMP programs (p < 0.05). Of the thirteen studies that reported on opioid-related adverse events, two found significant (p < 0.001 and p < 0.05) but conflicting results with one finding a decrease in opioid-related overdose deaths after PDMP implementation and the other an increase. Lastly, two studies found no statistically significant association between PDMP status and opioid-related legal and crime outcomes (crime rates, identification of potential dealers, and diversion). Our study found limited evidence to support overall associations between PDMPs and reductions in opioid-related consequences. However, this should not detract from the value of PDMPs' larger role of improving opioid prescribing.

Sections du résumé

BACKGROUND BACKGROUND
In order to address the opioid crisis in North America, many regions have adopted preventative strategies, such as prescription drug monitoring programs (PDMPs). PDMPs aim to increase patient safety by certifying that opioids are prescribed in appropriate quantities. We aimed to synthesize the literature on changes in opioid-related harms and consequences, an important measure of PDMP effectiveness.
METHODS METHODS
We completed a systematic review. We conducted a narrative synthesis of opioid-related harms and consequences from PDMP implementation. Outcomes were grouped into categories by theme: opioid dependence, opioid-related care outcomes, opioid-related adverse events, and opioid-related legal and crime outcomes.
RESULTS RESULTS
We included a total of 22 studies (49 PDMPs) in our review. Two studies reported on illicit and problematic use but found no significant associations with PDMP status. Eight studies examined the association between PDMP status and opioid-related care outcomes, of which two found that treatment admissions for prescriptions opioids were lower in states with PDMP programs (p < 0.05). Of the thirteen studies that reported on opioid-related adverse events, two found significant (p < 0.001 and p < 0.05) but conflicting results with one finding a decrease in opioid-related overdose deaths after PDMP implementation and the other an increase. Lastly, two studies found no statistically significant association between PDMP status and opioid-related legal and crime outcomes (crime rates, identification of potential dealers, and diversion).
CONCLUSION CONCLUSIONS
Our study found limited evidence to support overall associations between PDMPs and reductions in opioid-related consequences. However, this should not detract from the value of PDMPs' larger role of improving opioid prescribing.

Identifiants

DOI: 10.1186/s12913-019-4642-8 PMID: 31675963 PMC: PMC6825333
pubmed: 31675963
doi: 10.1186/s12913-019-4642-8
pii: 10.1186/s12913-019-4642-8
pmc: PMC6825333
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

784

Subventions

Organisme : CIHR
ID : 397982
Pays : Canada

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Auteurs

Emily Rhodes (E)

Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS, Canada.

Maria Wilson (M)

Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS, Canada.

Alysia Robinson (A)

Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS, Canada.

Jill A Hayden (JA)

Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS, Canada.

Mark Asbridge (M)

Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS, Canada. mark.asbridge@dal.ca.
Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada. mark.asbridge@dal.ca.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The effectiveness of prescription drug...
questionsmedicales.fr › Troubles mentaux › Troubles liés à une substance › Troubles liés à l'usage de substances psychotropes › Troubles liés aux opiacés › The effectiveness of prescription drug...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Services pharmaceutiques › Services d'information sur les médicaments › Programmes de surveillance des médicaments d'ordonnance › The effectiveness of prescription drug...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation de programme › The effectiveness of prescription drug...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études cliniques comme sujet › Essais cliniques comme sujet › Essais cliniques contrôlés comme sujet › Essais contrôlés randomisés comme sujet › The effectiveness of prescription drug...