title: Prescription monitoring programs and emergency department visits involving opioids, 2004-2011.
abstract: OBJECTIVE
  To determine the association between prescription drug monitoring program (PDMP) implementation and emergency department (ED) visits involving opioid analgesics.
  
  
  METHODS
  Rates of ED visits involving opioid analgesics per 100,000 residents were estimated from the Drug Abuse Warning Network dataset for 11 geographically diverse metropolitan areas in the United States on a quarterly basis from 2004 to 2011. Generalized estimating equations assessed whether implementation of a prescriber-accessible PDMP was associated with a difference in ED visits involving opioid analgesics. Models were adjusted for calendar quarter, metropolitan area, metropolitan area-specific linear time trends, and unemployment rate.
  
  
  RESULTS
  Rates of ED visits involving opioid analgesics increased in all metropolitan areas. PDMP implementation was not associated with a difference in ED visits involving opioid analgesics (mean difference of 0.8 visits [95% CI: -3.7 to 5.2] per 100,000 residents per quarter).
  
  
  CONCLUSIONS
  During 2004-2011, PDMP implementation was not associated with a change in opioid-related morbidity, as measured by emergency department visits involving opioid analgesics. Urgent investigation is needed to determine the optimal PDMP structure and capabilities to improve opioid analgesic safety.
authors.affiliation: Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: bmaughan@gmail.com.
authors.forename: Brandon C
authors.initials: BC
authors.lastname: Maughan
authors.affiliation: Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: marcus.bachhuber@gmail.com.
authors.forename: Marcus A
authors.initials: MA
authors.lastname: Bachhuber
authors.affiliation: Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. Electronic address: nanditam@mail.med.upenn.edu.
authors.forename: Nandita
authors.initials: N
authors.lastname: Mitra
authors.affiliation: Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA. Electronic address: jostarre@montefiore.org.
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Starrels
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D004335:Drug and Narcotic Control / Q000706:statistics & numerical data* / Q000639:trends; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data / Q000639:trends; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data; D014600:Utilization Review; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Emergency departments; Opioids; Prescription drug abuse; Prescription drug monitoring programs