Prescriber responses to a pain clinic law: Cease or modify?
Drug Alcohol Depend
; 206: 107591, 2020 01 01.
Article
in En
| MEDLINE
| ID: mdl-31765860
ABSTRACT
BACKGROUND:
Pain clinic laws are designed to cease or modify high-risk prescribing behavior. However, prior evaluations have not differentiated between these types of prescriber responses in their analysis, even though they may have different implications for patients. The purpose of this analysis is to investigate the effect of a 2016 Tennessee pain clinic law on the two types of prescriber responses.METHODS:
We used data on opioid prescriptions from the Tennessee Controlled Substances Monitoring Database (CSMD) between July 1st, 2015 and July 1st, 2017. Prescribers were assigned to the cessation or modification group based on the date of their last opioid prescription during the time period July 1st, 2015 to July 1st, 2018 and its relationship to the change in law. A risk score was developed based on five indicators to capture two categories of risky prescriber behavior increased risk for diversion or increased patient's risk of overdose. Within-prescriber differences were used to assess the effect of the law on several outcomes that capture the quantity and content of opioid prescriptions.RESULTS:
There was a significant decline in the number of prescriptions (cessation meanâ¯=â¯-45.18 pval<0.001; continuation meanâ¯=â¯-24.41 pval<0.001) and patients (cessation meanâ¯=â¯-16.68pval<0.001; continuation meanâ¯=â¯-10.92 pval<0.001) in both prescriber response groups, but the magnitude of decline was much larger in the cessation group. High-risk prescribers were more likely to cease prescribing than modify.CONCLUSIONS:
Prescribers who ceased prescribing in response to the pain clinic law disproportionately contributed to overall declines in opioid prescriptions.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Drug Prescriptions
/
Practice Patterns, Physicians'
/
Pain Clinics
/
Inappropriate Prescribing
/
Analgesics, Opioid
Type of study:
Prognostic_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Drug Alcohol Depend
Year:
2020
Document type:
Article