Past work demonstrates that mandated prescription drug monitoring programs (PDMPs) decrease opioid prescribing, but provides limited evidence on mechanisms. We analyze Kentucky's landmark PDMP mandate to disentangle the role of information versus hassle costs. PDMP mandates are meant to affect prescribing through information provision but may also unintentionally affect prescribing through the hassle cost of required record checks. On net, we find that although information clearly affected prescribing, hassle costs explain the majority of the decline in prescribing from this program. Hassle costs, however, did not deter physicians from prescribing opioids to the patients who would benefit the most.

Past work demonstrates that mandated prescription drug monitoring programs (PDMPs) decrease opioid prescribing, but provides limited evidence on mechanisms. We analyze Kentucky's landmark PDMP mandate to disentangle the role of information versus hassle costs. PDMP mandates are meant to affect prescribing through information provision but may also unintentionally affect prescribing through the hassle cost of required record checks. On net, we find that although information clearly affected prescribing, hassle costs explain the majority of the decline in prescribing from this program. Hassle costs, however, did not deter physicians from prescribing opioids to the patients who would benefit the most.

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

Filling a gap in the literature of the field, Factorial Survey Experiments provides researchers with a practical guide to using the factorial survey method to assess respondents’ beliefs about the world, judgment principles, or decision rules through multi-dimensional stimuli (“vignettes”) that resemble real-life decision-making situations. Using insightful examples to illustrate their arguments, authors Katrin Auspurg and Thomas Hinz guide researchers through all relevant steps, including how to set up the factorial experimental design (drawing samples of vignettes and respondents), how to handle the practical challenges that must be mastered when an experimental plan with many different treatments is embedded in a survey format, and how to deal with questions of data analysis. In addition to providing the “how-tos” of designing factorial survey experiments, the authors cover recent developments of similar methods, such as conjoint analyses, choice experiments, and more advanced statistical tools.

Background/Problem: The misuse, abuse, and diversion of controlled substances is a problematic health concern in the United States. Healthcare practitioners who prescribe controlled substances play an important role in prescribing and monitoring how these drugs are used. Purpose: The purpose of this quality improvement (QI) project was to identify perceived barriers prescribers face that hinder their ability to access and use the PDMP prior to prescribing controlled substances. Once barriers were identified, site-specific initiatives aimed at addressing barriers were developed and delivered. Methods: A pre- and post-intervention survey to assess prescriber knowledge and barriers related to PDMP use was developed, approved by IRB, and administered to a sample of prescribers in California, Florida, and Kansas. A mixed-method approach was used to collect qualitative and quantitative data. Pre-intervention survey analysis and appraisal of the literature guided site-specific initiatives developed to address prescriber barriers to using the PDMP. The interventions included an asynchronous video and PowerPoint presentation in California and Florida, and an in-person luncheon with discussion and PowerPoint presentation in Kansas. The QI team members provided the participants with a toolkit and resources specific to each site's needs to improve the utilization of the PDMP. The post-survey was conducted six weeks after the initial pre-survey review. Results: 22 participants responded to the preliminary survey. Out of the 22 participants, 18 respondents completed the post-survey questionnaire. The participants reported increased knowledge of accessing and using the PDMP, increased understanding of how to prescribe naloxone, and agreed that PDMP is an excellent tool for mitigating the controlled substance crisis. Conclusion: Targeted educational awareness can increase compliance with the PDMP and improve overall patient safety through safe controlled.

In response to the epidemic of prescription-drug abuse, now 49 US states have passed legislation to establish Prescription Drug Monitoring Programs (PDMPs). These programs track controlled-substance prescribing and usage behavior in an effort to improve patient outcomes and identify and preempt access by drug abusers. We exploit variation in the timing of implementation across states to identify the effectiveness of PDMPs on reducing opioid abuse. In particular, by considering the role of specific program attributes we offer the strongest evidence to date of the potential for PDMP-type policy to decrease opioid-related treatment admissions. We also consider heterogeneity across intensity and tenure of use, which reveals that the largest gains are coming from reductions in the number of less-attached users. Overall, these results have important implications for the effective re-design of PDMP policy.