Using a natural experiment design, investigators found that comprehensive use mandates requiring physician use of the PDMP were associated with a 9.2% reduction in the probability of overlapping opioid prescriptions, a 6.6% reduction in the probability of having 3 or more prescribers, and an 8% reduction in the probability of having overlapping opioid and benzodiazepine prescriptions. They did not observe an immediate effect on high dose opioid prescriptions although the estimated effect strengthened over time. Policies that allow prescribers to delegate access to office staff or other licensed professionals to reduce physician burden were associated with a 7.2% reduction in opioid prescriptions from more than 3 providers, a 4.3% reduction in high dose opioid prescriptions and a 1.8% reduction in overlapping opioid and benzodiazepine prescriptions, which strengthened overtime. Interstate Data Sharing that allow prescribers to view prescriptions in neighboring states were associated with a 2.6% reduction in having 3 or more prescribers, and an 2% reduction in overlapping opioid and benzodiazepine prescriptions. A reduction in overlapping opioid prescriptions and high dose opioid prescriptions was seen overtime.
Taken together these findings could have significant public health implications. Adoption of comprehensive use mandate policies resulted in a 6-9% reduction in almost all measures of high-risk prescription for commercially insured individuals. This translates to 36,000 fewer people having overlapping opioid prescriptions and 44,000 fewer people with overlapping opioid benzodiazepine prescriptions, for the non-elderly, privately insured population alone. Reduced morbidity and mortality associated with the reductions in high-risk opioid prescriptions for the entire population are likely substantial.
