Effect of Prescription Drug Monitoring Programs on Fatal, Nonfatal Drug Overdoses – Florence Chaverneff, Ph.D. – May 07, 2018
Evidence allowing us to assess the benefits and risks associated with prescription drug monitoring programs (PDMPs) is insufficient, according to a systematic review published in the Annals of Internal Medicine
Increases in the number of heroin overdoses were identified as an unintended consequence of PDMPs.
For this review, investigators sought to assess the effect of PDMPs on both fatal and nonfatal drug overdoses at the state and national levels through a literature review of 5 databases including Medline.
Of the initial 2661 articles identified, 17 studies (published between 2011 and 2018) were selected for review after exclusion of duplicates, of articles not following inclusion criteria, and of studies of a qualitative vs quantitative nature.
Studies evaluating specific PDMP features examined mainly PDMP registration/mandatory use by provider as well as association with fatal/nonfatal drug overdoses (n=1) and state authorization for access to PDMP data by provider
All studies investigating the effect of PDMP implementation on drug overdoses were found to have methodological limitations (eg, insufficient adjustments for confounding factors). Of studies examining the effect of post-PDMP implementation on rates of nonfatal drug overdoses, all had moderate to serious risk for bias
Of the 9 studies examining the relationship between specific administrative aspects of PDMPs and overdoses (fatal and nonfatal), the following features were found to result in reduced rates of overdoses:
- program data-sharing with other states (1 study),
- mandatory provider review (2 studies),
- monitoring of noncontrolled substances (3 studies),
- weekly (or more frequent) data update (2 studies), and
- reporting of patients’ history of prescribed controlled substances (1 study).
“Evidence that PDMP implementation either increases or decreases nonfatal or fatal overdoses is largely insufficient, as is evidence regarding any association between specific PDMP administrative features and nonfatal or fatal overdoses,” concluded the authors.
“The only exception is low-strength evidence of a reduction in fatal overdoses after implementation of PDMPs, specifically those that have mandatory provider review, authorize providers to access PDMP data, update data frequently, and monitor nonscheduled drugs
This article didn’t even mention some of the biggest issues with PDMP’s:
1. Health information privacy (from February 23, 2015):
2. Pushing opioid abusers toward dealy black-market opioids (from Fall 2017):