Evidence Lacking for Impact of PDMPs on Drug Overdoses
TUESDAY, May 8, 2018 -- There is insufficient evidence available for examining the correlation between prescription drug monitoring programs (PDMPs) and non-fatal or fatal overdoses, according to a review published online May 8 in the Annals of Internal Medicine.
David S. Fink, M.P.H., from Columbia University in New York City, and colleagues examined whether PDMP implementation correlates with changes in non-fatal and fatal overdoses and identifies features of programs differentially associated with those outcomes. A total of 17 articles met the inclusion criteria and were reviewed.
The articles examined PDMPs only, program features only, PDMP implementation and program features, PDMP implementation with mandated provider review combined with pain clinic laws, and PDMP robustness. The researchers found that three of the studies had insufficient evidence to draw conclusions regarding an association between PDMP implementation and non-fatal overdoses. Based on 10 studies, there was low-strength evidence for a reduction in fatal overdoses with PDMP implementation. A decrease in overdose deaths was seen in association with program features, including mandatory provider review, provider authorization to access PDMP data, frequency of reports, and monitoring of non-scheduled drugs. In three of six studies, after implementation of PDMPs there was an increase in heroin overdoses.
"Evidence that PDMP implementation either increases or decreases non-fatal or fatal overdoses is largely insufficient, as is evidence regarding positive associations between specific administrative features and successful programs," the authors write. "Some evidence showed unintended consequences."
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Posted: May 2018