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Le TT, Fleming SP, Kuzucan A, et al. Query mandates in prescription drug monitoring programs reduce opioid use among commercially insured patients with cancer. J Am Pharm Assoc (2003). 2021;doi: 10.1016/j.japh.2021.06.013.
Le, T. T., Fleming, S. P., Kuzucan, A., Dizik, A., & Simoni-Wastila, L. (2021). Query mandates in prescription drug monitoring programs reduce opioid use among commercially insured patients with cancer. Journal of the American Pharmacists Association : JAPhA, . https://doi.org/10.1016/j.japh.2021.06.013
Le, Tham Thi, et al. "Query mandates in prescription drug monitoring programs reduce opioid use among commercially insured patients with cancer." Journal of the American Pharmacists Association : JAPhA vol. (2021). doi: https://doi.org/10.1016/j.japh.2021.06.013
Le TT, Fleming SP, Kuzucan A, Dizik A, Simoni-Wastila L. Query mandates in prescription drug monitoring programs reduce opioid use among commercially insured patients with cancer. J Am Pharm Assoc (2003). 2021 Jun 15; doi: 10.1016/j.japh.2021.06.013. Epub 2021 Jun 15. PMID: 34246576.
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J Am Pharm Assoc (2003). 2021 Jun 15; doi: 10.1016/j.japh.2021.06.013. Epub 2021 Jun 15.

Query mandates in prescription drug monitoring programs reduce opioid use among commercially insured patients with cancer.

Journal of the American Pharmacists Association : JAPhA

Tham Thi Le, Sean P Fleming, Aida Kuzucan, Anna Dizik, Linda Simoni-Wastila

PMID: 34246576 DOI: 10.1016/j.japh.2021.06.013

Abstract

BACKGROUND: Prescription drug monitoring programs (PDMPs) have been shown to reduce opioid use in the general and noncancer populations. However, evidence of PDMP impacts on patients with cancer remains limited.

OBJECTIVE: The aim of the study was to examine the impact of PDMP mandates on individual-level opioid use among patients with cancer.

METHODS: This is a retrospective cohort study of patients with newly diagnosed cancer aged 18-65 years in the IQVIA PharMetrics Plus database (IQVIA Inc; nationally representative data of the U.S. commercially insured population in 49 states) between 2013 and 2015. The primary exposure was PDMP rigor (ranked from highest to lowest rigor): provider query + registration, query only, registration only, and unexposed. The study outcomes included (1) prevalent use among all individuals; and among opioid users (2) total days supplied, (3) daily morphine equivalent dose (MED), and (4) cumulative MED.

RESULTS: Of the eligible cohort (n=28,353), 37.5% (10,656) received opioids after a cancer diagnosis. The individuals exposed to these mandates were as follows: query + registration: 3899 (13.8%); query only: 3459 (12.2%); registration only: 2764 (9.7%); and no mandates: 18,231 (64.3%). The PDMP mandates had no effect on prevalent opioid use. Compared with unexposed patients, those subject to query mandates-alone or with registration mandates-experienced 12 fewer opioid days supplied and a lower mean cumulative MED (-662 mg and -702 mg, respectively), P < 0.01. Registration-only mandates were associated with 21 days more (P < 0.01) total days supplied and lower daily MED (1.1 mg; P < 0.05) but had no statistically significant effect on cumulative MED (-46 mg, P > 0.05).

CONCLUSION: Query mandates are a stronger PDMP tool than registration mandates in reducing opioid days supplied and cumulative MED. Initiatives should target PDMP mandates toward intended patient groups to reduce high-risk opioid use without compromising adequate pain treatment.

Copyright © 2021. Published by Elsevier Inc.

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