Abstract
BackgroundIn 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.MethodsWe 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.ResultsWe 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).ConclusionOur 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.
Highlights
In order to address the opioid crisis in North America, many regions have adopted preventative strategies, such as prescription drug monitoring programs (PDMPs)
A total of 161 articles were assessed at the full text level, resulting in the inclusion of 22 studies addressing the association of PDMP status with opioid-related consequences or harms
Opioidrelated consequences and harms are described in detail below and separated into the following four categories: illicit and problematic opioid use, opioid-related care outcomes, opioid-related adverse outcomes, and opioidrelated legal and criminal outcomes
Summary
In order to address the opioid crisis in North America, many regions have adopted preventative strategies, such as prescription drug monitoring programs (PDMPs). In order to address the opioid crisis many regions have adopted preventative initiatives, including physician mentoring, continuing medical education on pain management, naloxone kits, and, the focus of the current study, prescription drug monitoring programs (PDMPs). PDMPs facilitate controlled substances like opioids to be prescribed in appropriate quantities, following best practice guidelines, not co-prescribed with potentially harmful substances, and only provided to patients when safe and necessary [14]. This is achieved by monitoring the prescribing practices of healthcare providers and identifying any patterns of drugs received by patients. PDMPs aim to restrict drug diversion and reduce opioid misuse-related harms [18, 19]
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