The effect of an opioid prescription days’ supply limit on patients receiving long-term opioid treatment
Since 2016, an increasing number of states have passed laws restricting the days’ supply for opioid prescriptions, yet little is known about how these laws affect patients. This study evaluates the effect of the Tennessee Prescription Regulatory Act, which was implemented on Oct. 1st, 2013 and restr...
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| Veröffentlicht in: | The International journal of drug policy 2020-03, Vol.77, p.102662-102662, Article 102662 |
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| container_title | The International journal of drug policy |
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| creator | Yenerall, Jackie McPheeters, Melissa |
| description | Since 2016, an increasing number of states have passed laws restricting the days’ supply for opioid prescriptions, yet little is known about how these laws affect patients. This study evaluates the effect of the Tennessee Prescription Regulatory Act, which was implemented on Oct. 1st, 2013 and restricted the maximum days’ supply that could be dispensed for any opioid prescription by any prescriber to 30 days, on patients receiving long-term opioid treatment.
A quasi experimental model, an interrupted time series (ITS), was used with observational data to estimate the effect of the policy on monthly patient opioid prescription outcomes. Data for this study came from the Tennessee Controlled Substance Monitoring Database between October 1st, 2012 and October 31st, 2014. The study population included patients receiving long-term opioid treatment who filled an opioid prescription in at least 4 months in the 12-month pre-policy period and received at least one prescription in the pre-policy period with a days' supply exceeding 30 days. Three outcomes were measured each month for every patient based on their opioid prescriptions: per-prescription days’ supply per-prescription, daily morphine milligram equivalent (DMME), and total opioid prescriptions. All models controlled for individual fixed effects, age, and benzodiazepine prescriptions and utilized cluster robust standard errors to address serial correlation.
The change in law was associated with a decline in the average days’ supply by -5.30 days (95% CI: -5.64, -4.96), and number of prescriptions by -1.3% (95% CI: -3%, -0.07%), but an increase in the average DMME by 1.41 (95% CI: 0.37, 2.45).
Prescribers responded to the Addison Sharp Prescription Regulatory Act by significantly decreasing the days’ supply in opioid prescriptions among current patients receiving long-term opioid treatment who had at least one prescription exceeding the maximum days’ supply set by the law in the pre-policy period. |
| doi_str_mv | 10.1016/j.drugpo.2020.102662 |
| format | Article |
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A quasi experimental model, an interrupted time series (ITS), was used with observational data to estimate the effect of the policy on monthly patient opioid prescription outcomes. Data for this study came from the Tennessee Controlled Substance Monitoring Database between October 1st, 2012 and October 31st, 2014. The study population included patients receiving long-term opioid treatment who filled an opioid prescription in at least 4 months in the 12-month pre-policy period and received at least one prescription in the pre-policy period with a days' supply exceeding 30 days. Three outcomes were measured each month for every patient based on their opioid prescriptions: per-prescription days’ supply per-prescription, daily morphine milligram equivalent (DMME), and total opioid prescriptions. All models controlled for individual fixed effects, age, and benzodiazepine prescriptions and utilized cluster robust standard errors to address serial correlation.
The change in law was associated with a decline in the average days’ supply by -5.30 days (95% CI: -5.64, -4.96), and number of prescriptions by -1.3% (95% CI: -3%, -0.07%), but an increase in the average DMME by 1.41 (95% CI: 0.37, 2.45).
Prescribers responded to the Addison Sharp Prescription Regulatory Act by significantly decreasing the days’ supply in opioid prescriptions among current patients receiving long-term opioid treatment who had at least one prescription exceeding the maximum days’ supply set by the law in the pre-policy period.</description><identifier>ISSN: 0955-3959</identifier><identifier>EISSN: 1873-4758</identifier><identifier>DOI: 10.1016/j.drugpo.2020.102662</identifier><identifier>PMID: 31968287</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Age differences ; Analgesics, Opioid - administration & dosage ; Benzodiazepines ; Benzodiazepines - administration & dosage ; Cohort Studies ; Drug policy ; Errors ; Female ; Humans ; Law ; Male ; Medical treatment ; Middle Aged ; Morphine ; Narcotics ; Opioids ; Patients ; Policy analysis ; Practice Patterns, Physicians' - legislation & jurisprudence ; Prescription Drug Misuse - prevention & control ; Prescription drugs ; Prescription limits ; Prescription opioids ; Prescriptions ; Quasi-experimental methods ; State laws ; Substance abuse treatment ; Tennessee ; Time series</subject><ispartof>The International journal of drug policy, 2020-03, Vol.77, p.102662-102662, Article 102662</ispartof><rights>2020 Elsevier B.V.</rights><rights>Copyright © 2020 Elsevier B.V. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Mar 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-1d7ef18714ec66becd5a9b83ada4d170a23f0c8e72835b4858e33ad4774869df3</citedby><cites>FETCH-LOGICAL-c390t-1d7ef18714ec66becd5a9b83ada4d170a23f0c8e72835b4858e33ad4774869df3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.drugpo.2020.102662$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27845,27903,27904,30978,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31968287$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yenerall, Jackie</creatorcontrib><creatorcontrib>McPheeters, Melissa</creatorcontrib><title>The effect of an opioid prescription days’ supply limit on patients receiving long-term opioid treatment</title><title>The International journal of drug policy</title><addtitle>Int J Drug Policy</addtitle><description>Since 2016, an increasing number of states have passed laws restricting the days’ supply for opioid prescriptions, yet little is known about how these laws affect patients. This study evaluates the effect of the Tennessee Prescription Regulatory Act, which was implemented on Oct. 1st, 2013 and restricted the maximum days’ supply that could be dispensed for any opioid prescription by any prescriber to 30 days, on patients receiving long-term opioid treatment.
A quasi experimental model, an interrupted time series (ITS), was used with observational data to estimate the effect of the policy on monthly patient opioid prescription outcomes. Data for this study came from the Tennessee Controlled Substance Monitoring Database between October 1st, 2012 and October 31st, 2014. The study population included patients receiving long-term opioid treatment who filled an opioid prescription in at least 4 months in the 12-month pre-policy period and received at least one prescription in the pre-policy period with a days' supply exceeding 30 days. Three outcomes were measured each month for every patient based on their opioid prescriptions: per-prescription days’ supply per-prescription, daily morphine milligram equivalent (DMME), and total opioid prescriptions. All models controlled for individual fixed effects, age, and benzodiazepine prescriptions and utilized cluster robust standard errors to address serial correlation.
The change in law was associated with a decline in the average days’ supply by -5.30 days (95% CI: -5.64, -4.96), and number of prescriptions by -1.3% (95% CI: -3%, -0.07%), but an increase in the average DMME by 1.41 (95% CI: 0.37, 2.45).
Prescribers responded to the Addison Sharp Prescription Regulatory Act by significantly decreasing the days’ supply in opioid prescriptions among current patients receiving long-term opioid treatment who had at least one prescription exceeding the maximum days’ supply set by the law in the pre-policy period.</description><subject>Age differences</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Benzodiazepines</subject><subject>Benzodiazepines - administration & dosage</subject><subject>Cohort Studies</subject><subject>Drug policy</subject><subject>Errors</subject><subject>Female</subject><subject>Humans</subject><subject>Law</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Morphine</subject><subject>Narcotics</subject><subject>Opioids</subject><subject>Patients</subject><subject>Policy analysis</subject><subject>Practice Patterns, Physicians' - legislation & jurisprudence</subject><subject>Prescription Drug Misuse - prevention & control</subject><subject>Prescription drugs</subject><subject>Prescription limits</subject><subject>Prescription opioids</subject><subject>Prescriptions</subject><subject>Quasi-experimental methods</subject><subject>State laws</subject><subject>Substance abuse treatment</subject><subject>Tennessee</subject><subject>Time series</subject><issn>0955-3959</issn><issn>1873-4758</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>7TQ</sourceid><recordid>eNp9kc2K1TAYhoMoznH0DkQCbtz0mN8m3QgyqCMMuBnXISf5ekxpm5qkA2fnbXh7Xok5dMbFLFwFkud7kzwvQq8p2VNC2_fD3qf1uMQ9I-y8xdqWPUE7qhVvhJL6KdqRTsqGd7K7QC9yHgghggr6HF1w2rWaabVDw-0PwND34AqOPbYzjkuIweMlQXYpLCXEGXt7yn9-_cZ5XZbxhMcwhYrPeLElwFwyTuAg3IX5iMc4H5sCaXoIKglsmSr1Ej3r7Zjh1f16ib5__nR7dd3cfPvy9erjTeN4R0pDvYK-_oIKcG17AOel7Q6aW2-Fp4pYxnviNCimuTwILTXweiiUErrtfM8v0bstd0nx5wq5mClkB-NoZ4hrNowLwZjWVFb07SN0iGua6-sMq1DVJIWqlNgol2LOCXqzpDDZdDKUmHMXZjBbF-bchdm6qGNv7sPXwwT-39CD_Ap82ACoNu4CJJNd1enAh-qzGB_D_2_4C7HnnkI</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Yenerall, Jackie</creator><creator>McPheeters, Melissa</creator><general>Elsevier B.V</general><general>Elsevier Science Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TQ</scope><scope>8BJ</scope><scope>DHY</scope><scope>DON</scope><scope>FQK</scope><scope>JBE</scope><scope>7X8</scope></search><sort><creationdate>202003</creationdate><title>The effect of an opioid prescription days’ supply limit on patients receiving long-term opioid treatment</title><author>Yenerall, Jackie ; McPheeters, Melissa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-1d7ef18714ec66becd5a9b83ada4d170a23f0c8e72835b4858e33ad4774869df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age differences</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Benzodiazepines</topic><topic>Benzodiazepines - administration & dosage</topic><topic>Cohort Studies</topic><topic>Drug policy</topic><topic>Errors</topic><topic>Female</topic><topic>Humans</topic><topic>Law</topic><topic>Male</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>Morphine</topic><topic>Narcotics</topic><topic>Opioids</topic><topic>Patients</topic><topic>Policy analysis</topic><topic>Practice Patterns, Physicians' - legislation & jurisprudence</topic><topic>Prescription Drug Misuse - prevention & control</topic><topic>Prescription drugs</topic><topic>Prescription limits</topic><topic>Prescription opioids</topic><topic>Prescriptions</topic><topic>Quasi-experimental methods</topic><topic>State laws</topic><topic>Substance abuse treatment</topic><topic>Tennessee</topic><topic>Time series</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yenerall, Jackie</creatorcontrib><creatorcontrib>McPheeters, Melissa</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>PAIS Index</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>MEDLINE - Academic</collection><jtitle>The International journal of drug policy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yenerall, Jackie</au><au>McPheeters, Melissa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of an opioid prescription days’ supply limit on patients receiving long-term opioid treatment</atitle><jtitle>The International journal of drug policy</jtitle><addtitle>Int J Drug Policy</addtitle><date>2020-03</date><risdate>2020</risdate><volume>77</volume><spage>102662</spage><epage>102662</epage><pages>102662-102662</pages><artnum>102662</artnum><issn>0955-3959</issn><eissn>1873-4758</eissn><abstract>Since 2016, an increasing number of states have passed laws restricting the days’ supply for opioid prescriptions, yet little is known about how these laws affect patients. This study evaluates the effect of the Tennessee Prescription Regulatory Act, which was implemented on Oct. 1st, 2013 and restricted the maximum days’ supply that could be dispensed for any opioid prescription by any prescriber to 30 days, on patients receiving long-term opioid treatment.
A quasi experimental model, an interrupted time series (ITS), was used with observational data to estimate the effect of the policy on monthly patient opioid prescription outcomes. Data for this study came from the Tennessee Controlled Substance Monitoring Database between October 1st, 2012 and October 31st, 2014. The study population included patients receiving long-term opioid treatment who filled an opioid prescription in at least 4 months in the 12-month pre-policy period and received at least one prescription in the pre-policy period with a days' supply exceeding 30 days. Three outcomes were measured each month for every patient based on their opioid prescriptions: per-prescription days’ supply per-prescription, daily morphine milligram equivalent (DMME), and total opioid prescriptions. All models controlled for individual fixed effects, age, and benzodiazepine prescriptions and utilized cluster robust standard errors to address serial correlation.
The change in law was associated with a decline in the average days’ supply by -5.30 days (95% CI: -5.64, -4.96), and number of prescriptions by -1.3% (95% CI: -3%, -0.07%), but an increase in the average DMME by 1.41 (95% CI: 0.37, 2.45).
Prescribers responded to the Addison Sharp Prescription Regulatory Act by significantly decreasing the days’ supply in opioid prescriptions among current patients receiving long-term opioid treatment who had at least one prescription exceeding the maximum days’ supply set by the law in the pre-policy period.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>31968287</pmid><doi>10.1016/j.drugpo.2020.102662</doi><tpages>1</tpages></addata></record> |
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| source | MEDLINE; PAIS Index; Elsevier ScienceDirect Journals; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Age differences Analgesics, Opioid - administration & dosage Benzodiazepines Benzodiazepines - administration & dosage Cohort Studies Drug policy Errors Female Humans Law Male Medical treatment Middle Aged Morphine Narcotics Opioids Patients Policy analysis Practice Patterns, Physicians' - legislation & jurisprudence Prescription Drug Misuse - prevention & control Prescription drugs Prescription limits Prescription opioids Prescriptions Quasi-experimental methods State laws Substance abuse treatment Tennessee Time series |
| title | The effect of an opioid prescription days’ supply limit on patients receiving long-term opioid treatment |
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