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Letter Intervention Ups Prescription Monitoring Program Engagement

Letters highlighting mandate to check PMP before prescribing can increase PMP search rates and PMP account-holding rates

By Elana Gotkine HealthDay Reporter

TUESDAY, Jan. 10, 2023 (HealthDay News) — A simple letter intervention highlighting a new mandate to check the prescription monitoring program (PMP) before prescribing controlled substances, with or without information about coprescribing risks and coprescribed patients, can increase PMP engagement, according to a report published in the January issue of Health Affairs.

Noting that almost all states operate PMPs to facilitate safer prescribing of opioids and other drugs, Adam Sacarny, Ph.D., from Columbia University in New York City, and colleagues conducted a randomized trial to examine whether letters to physicians increase use of the PMP and decrease coprescribing of opioids with benzodiazepines or gabapentinoids. A total of 12,000 coprescribers were randomly assigned to a control arm or one of three study arms sent differing letters, which highlighted a new mandate to check the PMP before prescribing, provided information about coprescribing risks with a list of coprescribed patients, or contained both messages.

The researchers found that PMP search rates were increased by 4.5 and 4.0 percent with letters highlighting the mandate alone or letters highlighting the mandate and coprescribing information, respectively, but no significant impact was seen on coprescribing. An increase in PMP account-holding rates was also seen in association with these letters. These effects lasted for eight months or longer. No effect on key outcomes was seen for the letter with only coprescribing information.

“For policy makers and organizations seeking to promote clinician engagement with PMPs to make prescribing safer, these results add to the evidence-based toolkit,” the authors write. “Notably, they demonstrate that simple-to-populate messages without identifying patient information can be effective.”

One author disclosed receipt of personal fees for serving as an expert witness in lawsuits against opioid manufacturers and distributors.

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