Prescription Drug Monitoring and Dispensing of Prescription Opioids
Prescription Drug Monitoring and Dispensing of Prescription Opioids
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DOI：
10.1177/003335491412900207
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发表时间：
2014-03-01
影响因子：
3.3
通讯作者：
Li, Guohua
中科院分区：
文献类型：
--
作者：
Brady, Joanne E.;Wunsch, Hannah;Li, Guohua
Objective.在美国，自1990年代以来，人均类阿片配药量与止痛剂相关死亡率和发病率同时增加。为了阻止受控物质的转移和滥用，大多数州都实施了电子处方药监测计划（PDMP）。我们评估了州PDMP对阿片类药物分配的影响。我们从报告自动化和综合订单系统中获取了1999年至2008年每个州和哥伦比亚特区在一年中给定季度分发的阿片类药物的数据，并将其转换为吗啡毫克当量（MME）。我们使用多变量线性回归模型和广义估计方程来评估州PDMP对MME人均分配的影响。每年人均分配的微型医疗设备数量逐渐增加，直到2007年才稳定下来。根据时间趋势和人口特征进行调整后，州PDMP的实施与人均分配的MME减少3%相关（p=0.68）。PDMP对人均分配的MME的影响因州而异，从科罗拉多的66%下降到康涅狄格州的61%。截至2008年，州PDMP的实施并未对人均阿片类药物分配产生重大影响。为了控制处方药的转移和滥用，州PDMP可能需要提高其可用性，实施委员会监督处方药的要求，并增加与邻国的数据共享。
Objective. In the United States, per-capita opioid dispensing has increased concurrently with analgesic-related mortality and morbidity since the 1990s. To deter diversion and abuse of controlled substances, most states have implemented electronic prescription drug monitoring programs (PDMPs). We evaluated the impact of state PDMPs on opioid dispensing.Methods. We acquired data on opioids dispensed in a given quarter of the year for each state and the District of Columbia from 1999 to 2008 from the Automation of Reports and Consolidated Orders System and converted them to morphine milligram equivalents (MMEs). We used multivariable linear regression modeling with generalized estimating equations to assess the effect of state PDMPs on per-capita dispensing of MMEs.Results. The annual MMEs dispensed per capita increased progressively until 2007 before stabilizing. Adjusting for temporal trends and demographic characteristics, implementation of state PDMPs was associated with a 3% decrease in MMEs dispensed per capita (p=0.68). The impact of PDMPs on MMEs dispensed per capita varied markedly by state, from a 66% decrease in Colorado to a 61% increase in Connecticut.Conclusions. Implementation of state PDMPs up to 2008 did not show a significant impact on per-capita opioids dispensed. To control the diversion and abuse of prescription drugs, state PDMPs may need to improve their usability, implement requirements for committee oversight of the PDMP, and increase data sharing with neighboring states.