Impact of a State Opioid Prescribing Limit and Electronic Medical Record Alert on Opioid Prescriptions: a Difference-in-
- PDF / 901,839 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 67 Downloads / 203 Views
National Clinician Scholars Program, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; 2Department of Medicine, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA; 3The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; 4Data Analytics Center, Penn Medicine, Philadelphia, PA, USA; 5Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 6Division of General Internal Medicine, Perelman School of School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; 7Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; 8 Department of Anesthesia and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
BACKGROUND: Prescribing limits are one policy strategy to reduce short-term opioid prescribing, but there is limited evidence of their impact. OBJECTIVE: Evaluate implementation of a state prescribing limit law and health system electronic medical record (EMR) alert on characteristics of new opioid prescriptions, refill rates, and clinical encounters. DESIGN: Difference-in-differences study comparing new opioid prescriptions from ambulatory practices in New Jersey (NJ) to controls in Pennsylvania (PA) from 1 year prior to the implementation of a NJ state prescribing limit (May 2016–May 2017) to 10 months after (May 2017– March 2018). PARTICIPANTS: Adults with new opioid prescriptions in an academic health system with practices in PA and NJ. INTERVENTIONS: State 5-day opioid prescribing limit plus health system and health system EMR alert. MAIN MEASURES: Changes in morphine milligram equivalents (MME) and tablet quantity per prescription, refills, and encounters, adjusted for patient and prescriber characteristics. KEY RESULTS: There were a total of 678 new prescriptions in NJ and 4638 in PA. Prior to the intervention, median MME/prescription was 225 mg in NJ and 150 mg in PA, and median quantity was 30 tablets in both. After implementation, median MME/prescription was 150 mg in both states, and median quantity was 20 in NJ and 30 in PA. In the adjusted model, there was a greater decrease in mean MME and tablet quantity in NJ Prior Presentations Preliminary results were presented at the Annual Meeting of the National Clinician Scholars Program on October 18, 2018, in Los Angeles, CA, the Society of General Internal Medicine Annual Meeting on May 9, 2019, in Washington, DC, and the Academy Health Annual Research Meeting on June 3, 2019 in Washington, DC. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11606-019-05302-1) contains supplementary material, which is available to authorized users. Received December 27, 2018 Revised April 24, 2019 Accepted July 25, 2019
relative to PA after implementation of the policy pl
Data Loading...
