Comparing Changes in Controlled Substance Prescribing Trends by Provider Type.

Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9208821 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1521-0391 (Electronic) Linking ISSN: 10550496 NLM ISO Abbreviation: Am J Addict Subsets: MEDLINE

Publication: Oxford : Wiley-Blackwell
Original Publication: Washington, DC : American Psychiatric Press, c1992-

Controlled Substances*; Practice Patterns, Physicians'/*trends ; Prescription Drug Monitoring Programs/*trends; Analgesics, Opioid/therapeutic use ; Central Nervous System Stimulants/therapeutic use ; Dentists/statistics & numerical data ; Humans ; Kentucky ; Nurses/statistics & numerical data ; Physicians/statistics & numerical data ; Practice Patterns, Physicians'/statistics & numerical data ; Prescription Drug Monitoring Programs/statistics & numerical data

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).
(Copyright © 2019 American Academy of Addiction Psychiatry.)

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UL1 TR001998 United States TR NCATS NIH HHS

0 (Analgesics, Opioid)
0 (Central Nervous System Stimulants)
0 (Controlled Substances)

Date Created: 20191011 Date Completed: 20200907 Latest Revision: 20240327

20240327

PMC6941737

10.1111/ajad.12962

31600029