Robust Prescription Monitoring Programs and Abrupt Discontinuation of Long-term Opioid Use

In recent years, state Prescription Drug Monitoring Programs (PDMPs) have grown more widespread while previously used long-term opioid therapies have been discontinued. A question stemming from this related to the association of levels of robustness across PDMPs and how abruptly long-term opioid therapies were discontinued. Dr. Yuhua Bao, associate professor of population health sciences; Dr. Hao Zhang, research associate in population health sciences; Dr. Bruce Schackman, professor of population health sciences; Phyllis Johnson, programmer analyst in population health sciences; Philip Jeng, research manager in population health sciences; and colleagues from Cornell University and Weill Cornell Medicine examined this in a new American Journal of Preventive Medicine study. The researchers used data from a national commercial insurance database which included privately insured adults aged 18 to 64 years and Medicare Advantage enrollees aged 65 years and older who initiated a long-term opioid therapy episode between 2011 and 2017. State PDMPs were categorized as nonrobust, robust, and strongly robust, while abrupt discontinuation was measured based on high daily morphine milligram equivalents over the last 30 days of a long-term opioid therapy episode or no sign of tapering before discontinuation. They found that discontinuation without tapering was most common for long-term opioid therapies in the study. However, policies to enhance the use and robustness of PDMPs were not associated with increases in abrupt long-term opioid therapy discontinuation.

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