Background: To date, there is limited research on whether the various types of mandatory usage
of prescription drug monitoring programs (PDMP) have any effects on prescribing patterns, drug
usage, patient care, and drug diversion (8-10). Within the United States (US), there is wide variation
in individual states’ requirements for the usage of PDMPs.
Objective: The objective of this study was to determine whether mandatory prescriber review of
a PDMP prior to each issuance of a controlled substance resulted in a reduction in the total number
of controlled substance prescriptions dispensed.
Study Design: A retrospective review of the State of Wisconsin’s PDMP controlled substance
database from April 2015 to March 2019 was performed. The evaluation compared the number
of prescriptions among individual drug classes (opioids, benzodiazepines, stimulants) dispensed
throughout the state before and after April 1st, 2017, when implementation of a state law
mandating the review of the PDMP during each patient encounter prior to issuing a prescription
for a controlled substance took effect.
Setting: Research was conducted using Wisconsin’s PDMP controlled substance database from
April 2015 to March 2019. During this time, controlled substance policy has come to the forefront
of the nation due to issues with an opioid epidemic.
Methods: Descriptive analysis was used to express data as n and % for categorical data and
average ± standard deviation for numerical data. Before- and after-prescription totals were
analyzed using a paired t test and Levene’s test for equality of variances. The P value was considered
significant at a level ≤ .05.
Limitations: Limitations to this study included its retrospective design, focus on a single US state,
and possible unforeseen contributors to cause and effect.
Results: Prior to the enforcement of the state’s mandatory PDMP legislation, an average of
844,314 controlled substance prescriptions were written monthly. Following the implementation
of the law, the average monthly total prescriptions written within the state decreased to 708,063.
This was an average monthly reduction of 136,251 prescriptions written or 16.1%. Statistically
significant reductions were also seen in opioid and benzodiazepine subgroups (23.0%, 16.3%).
Conclusion: Our study suggests that state-enforced mandatory usage of a PDMP, which records
all controlled substance prescriptions filled by a pharmacy such as opioids, benzodiazepines,
amphetamines, etc. at every encounter prior to prescribing any controlled substance, can
provide for a significant reduction in controlled substance prescriptions, specifically opioids and
benzodiazepines.
Key words: Prescription drug monitoring program, opioids, mandatory usage, benzodiazepines,
Wisconsin
Opioid Prescribing Patterns and Patient Outcomes by Prescriber Type in the Oregon Prescription Drug Monitoring Program
