TY - JOUR
T1 - Impact of Florida's prescription drug monitoring program and pill mill law on high-risk patients
T2 - A comparative interrupted time series analysis
AU - Chang, Hsien Yen
AU - Murimi, Irene B
AU - Faul, Mark
AU - Rutkow, Lainie
AU - Alexander, G. Caleb
N1 - Funding Information:
The statements, findings, conclusions, views, and opinions contained and expressed in this article are based in part on data obtained under license from the following IMS Health Incorporated information service(s): QuintilesIMS Health LifeLink LRx Database® (2010‐2012), QuintilesIMS Health Incorporated. All Rights Reserved. The statements, findings, conclusions, views, and opinions contained and expressed herein are not necessarily those of QuintilesIMS Health Incorporated or any of its affiliated or subsidiary entities. This work was funded by the Robert Wood Johnson Foundation Public Health Law Research Program and the Centers for Disease Control and Prevention under cooperative agreement U01CE002499. The funding sources had no role in the design and conduct of the study, analysis, or interpretation of the data and preparation or final approval of the manuscript prior to publication. The opinions and conclusions expressed are solely of the author(s) and should not be construed as representing the opinions of CDC or any agency of the federal government.
Funding Information:
The statements, findings, conclusions, views, and opinions contained and expressed in this article are based in part on data obtained under license from the following IMS Health Incorporated information service(s): QuintilesIMS Health LifeLink LRx Database? (2010-2012), QuintilesIMS Health Incorporated. All Rights Reserved. The statements, findings, conclusions, views, and opinions contained and expressed herein are not necessarily those of QuintilesIMS Health Incorporated or any of its affiliated or subsidiary entities. This work was funded by the Robert Wood Johnson Foundation Public Health Law Research Program and the Centers for Disease Control and Prevention under cooperative agreement U01CE002499. The funding sources had no role in the design and conduct of the study, analysis, or interpretation of the data and preparation or final approval of the manuscript prior to publication. The opinions and conclusions expressed are solely of the author(s) and should not be construed as representing the opinions of CDC or any agency of the federal government.
Publisher Copyright:
Copyright © 2018 John Wiley & Sons, Ltd.
PY - 2018/4
Y1 - 2018/4
N2 - Purpose: We quantified the effects of Florida's prescription drug monitoring program and pill mill law on high-risk patients. Methods: We used QuintilesIMS LRx Lifelink data to identify patients receiving prescription opioids in Florida (intervention state, N: 1.13 million) and Georgia (control state, N: 0.54 million). The preintervention, intervention, and postintervention periods were July 2010 to June 2011, July 2011 to September 2011, and October 2011 to September 2012. We identified 3 types of high-risk patients: (1) concomitant users: patients with concomitant use of benzodiazepines and opioids; (2) chronic users: long-term, high-dose, opioid users; and (3) opioid shoppers: patients receiving opioids from multiple sources. We compared changes in opioid prescriptions between Florida and Georgia before and after policy implementation among high-risk/low-risk patients. Our monthly measures included (1) average morphine milligram equivalent per transaction, (2) total opioid volume across all prescriptions, (3) average days supplied per transaction, and (4) total number of opioid prescriptions dispensed. Results: Among opioid-receiving individuals in Florida, 6.62% were concomitant users, 1.96% were chronic users, and 0.46% were opioid shoppers. Following policy implementation, Florida's high-risk patients experienced relative reductions in morphine milligram equivalent (opioid shoppers: −1.08 mg/month, 95% confidence interval [CI] −1.62 to −0.54), total opioid volume (chronic users: −4.58 kg/month, CI −5.41 to −3.76), and number of dispensed opioid prescriptions (concomitant users: −640 prescriptions/month, CI −950 to −340). Low-risk patients generally did not experience statistically significantly relative reductions. Conclusions: Compared with Georgia, Florida's prescription drug monitoring program and pill mill law were associated with large relative reductions in prescription opioid utilization among high-risk patients.
AB - Purpose: We quantified the effects of Florida's prescription drug monitoring program and pill mill law on high-risk patients. Methods: We used QuintilesIMS LRx Lifelink data to identify patients receiving prescription opioids in Florida (intervention state, N: 1.13 million) and Georgia (control state, N: 0.54 million). The preintervention, intervention, and postintervention periods were July 2010 to June 2011, July 2011 to September 2011, and October 2011 to September 2012. We identified 3 types of high-risk patients: (1) concomitant users: patients with concomitant use of benzodiazepines and opioids; (2) chronic users: long-term, high-dose, opioid users; and (3) opioid shoppers: patients receiving opioids from multiple sources. We compared changes in opioid prescriptions between Florida and Georgia before and after policy implementation among high-risk/low-risk patients. Our monthly measures included (1) average morphine milligram equivalent per transaction, (2) total opioid volume across all prescriptions, (3) average days supplied per transaction, and (4) total number of opioid prescriptions dispensed. Results: Among opioid-receiving individuals in Florida, 6.62% were concomitant users, 1.96% were chronic users, and 0.46% were opioid shoppers. Following policy implementation, Florida's high-risk patients experienced relative reductions in morphine milligram equivalent (opioid shoppers: −1.08 mg/month, 95% confidence interval [CI] −1.62 to −0.54), total opioid volume (chronic users: −4.58 kg/month, CI −5.41 to −3.76), and number of dispensed opioid prescriptions (concomitant users: −640 prescriptions/month, CI −950 to −340). Low-risk patients generally did not experience statistically significantly relative reductions. Conclusions: Compared with Georgia, Florida's prescription drug monitoring program and pill mill law were associated with large relative reductions in prescription opioid utilization among high-risk patients.
KW - chronic opioid users
KW - concomitant users of benzodiazepines and opioids
KW - long-term opioid therapy
KW - opioid shoppers
KW - pharmacoepidemiology
KW - pill mill law
KW - prescription drug abuse
KW - prescription drug monitoring program
KW - time series analysis
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U2 - 10.1002/pds.4404
DO - 10.1002/pds.4404
M3 - Article
C2 - 29488663
AN - SCOPUS:85042550599
SN - 1053-8569
VL - 27
SP - 422
EP - 429
JO - Pharmacoepidemiology and Drug Safety
JF - Pharmacoepidemiology and Drug Safety
IS - 4
ER -