Opioid Use
Conditions
Keywords
opioids, prescribing, benzodiazepines, gabapentinoids, clinical guidelines, overprescribing, Benzodiazepine Use, Gabapentin Use
Brief summary
Despite an enormous policy response, opioid prescribing remains well above historical levels and harms from opioids continue to mount. Nearly all states have Prescription Monitoring Programs (PMPs) to facilitate safer prescribing of opioids and other drugs, but research suggests these systems only deliver benefits when health care professionals are required to use them. Even with PMP mandates in place, providers may be unaware of the dangers of co-prescribing opioids with benzodiazepines or gabapentinoids, which include increased risk of overdose and death. Working with the Minnesota state government, the investigators will mail letters to guideline-discordant opioid prescribers that either highlight an upcoming legally mandated requirement to check the PMP before prescribing an opioid, inform and educate providers about patients filling concurrent prescriptions and the dangers of such co-prescribing, or both. Study participants will be randomized to receive no intervention or one of the three treatment letters. Using administrative data, the investigators will track effects of the letters on not only prescribing but also PMP usage and queries. Findings form the multiplicity of treatment messages and outcomes will shed light on the mechanisms driving overprescribing. Results will inform future work by state and local policymakers to make opioid prescribing safer.
Interventions
A letter with reminders about the mandate to check the PMP when prescribing opioids.
A letter with information about the prescriber's patients who received co-prescriptions. The letters will provide clinical background on the harms of co-prescribing and encourage prescribers to avoid co-prescribing in the future.
A letter combining the content of the PMP Use Mandate Letter and the Prescribing Information Letter. This letter will remind prescribers about the PMP use mandate and provide information about the prescriber's patients who received co-prescriptions.
Sponsors
Study design
Eligibility
Inclusion criteria
* Wrote concurrent prescription for opioids and benzodiazepines OR opioids and gabapentinoids
Exclusion criteria
* Specialization in oncology or palliative medicine
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Count of Patients with Co-Prescriptions | 60 days | The number of patients with co-prescriptions from the prescriber in the 60 days after the letters are sent. |
| Rate of Prescribers Checking PMP | 60 days | Indicator for whether the prescriber checks the PMP at least once in the 60 days after the letters are sent. |
Countries
United States