Background and Objectives: Forty-nine out of 50 states have implemented Prescription Drug Monitoring Programs (PDMPs) to monitor controlled substance (CS) prescribing. PDMPs change health care provider behavior, but few studies have examined changes in CS prescription by health care provider type. Methods: Aggregated yearly data, including number of CS prescriptions, doses, and doses per prescription by health care provider type (physician, advanced practice registered nurse [APRN], and dentist) for each year from 2011 to 2017 was provided by the state PDMP, Kentucky All Schedule Prescription Electronic Reporting System (KASPER). In aggregate, this data set included 64,578,307 total prescriptions and 3,982,130,994 total doses of Schedule II–V medications. Results: Physicians and dentists showed a trend of decreasing prescriptions and doses for Schedule II opioids from 2012 to 2017 (27-32% reduction in 2017 compared to 2011). APRNs showed a substantive increase in the number of doses and prescriptions (121-204% increase in 2017 compared to 2011), with increases remaining when controlling for number of providers. Physicians increased doses and prescriptions of Schedule II stimulants (37% increase for both doses and prescriptions), but by a smaller magnitude than APRN increases in stimulants (334-360% increase). Dentists showed decreases in Schedule II stimulants prescribed (69-80% reduction). Similar trends, but more modest in magnitude, were observed for Schedule III–IV. Discussion and Conclusions: Although monitoring and continuing education requirements are similar across all providers in Kentucky, differences in prescription trends for Schedule II opioids and stimulants were noted for physicians, APRNs, and dentists. Scientific Significance: Changes in prescribing following introduction of mandatory use of KASPER markedly differed based on provider type, with increases observed for APRNs compared with physicians and dentists. These findings advance prior research by providing a detailed examination of prescribing trends by provider type subsequent to a PDMPs mandatory use law. (Am J Addict 2019;00:00–00).
|Number of pages||8|
|Journal||American Journal on Addictions|
|State||Published - Jan 1 2020|
Bibliographical noteFunding Information:
Salary support for ALM while preparing this manuscript was provided by the University of Kentucky College of Medicine SChoLAR Physician-Scientist Career Development Program, Lexington, KY. The project described was supported by the NIH National Center for Advancing Translational Sciences through grant number UL1TR001998. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. These data were previously presented at the poster session of the American Academy of Addiction Psychiatry in December 2018. We thank David Hopkins of Kentucky Cabinet for Health and Family Sciences (CHFS) for assistance with data.
Copyright © 2019 American Academy of Addiction Psychiatry
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Clinical Psychology
- Psychiatry and Mental health