TY - JOUR
KW - Analgesics, Opioid/adverse effects
KW - Cause of Death
KW - Drug Overdose/mortality/prevention & control
KW - Drug Prescriptions
KW - Health Policy/legislation & jurisprudence
KW - Humans
KW - Inappropriate Prescribing/mortality/prevention & control
KW - Models, Organizational
KW - Opioid-Related Disorders/mortality/prevention & control
KW - Patient Safety
KW - Policy Making
KW - Practice Patterns, Physicians'/legislation & jurisprudence/organization & administration
KW - Prescription Drug Misuse/mortality/prevention & control
KW - Regional Health Planning/legislation & jurisprudence/organization & administration
KW - Risk Assessment
KW - Risk Factors
KW - State Government
KW - State Health Plans/legislation & jurisprudence/organization & administration
AU - F. L. Beaudoin
AU - G. N. Banerjee
AU - M. J. Mello
A1 - 
AB - OBJECTIVE: In response to persistent public health concerns regarding prescription opioids, many states and healthcare systems have implemented legislation and policies intended to regulate or guide opioid prescribing. The overall impact of these policies is still uncertain. The aim of this systematic review was to examine the existing evidence of provider-level and patient-level outcomes preimplementation and postimplementation of policies and legislation constructed to impact provider prescribing practices around opioid analgesics. DESIGN: A systematic search of MEDLINE, EMBASE, the Web of Science, and the Cochrane Database of Systematic Reviews was conducted to identify studies evaluating the impact of opioid prescribing policies on provider-level and patient-level outcomes. The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Eleven studies were included in the review. A meta-analysis was not possible due to between-study heterogeneity. Six of the studies assessed state-level policies, and five were at the level of the healthcare system or hospital. Studies showed temporal associations between policy implementation and reductions in opioid prescribing, as well as opioid-related overdoses. Results were mixed regarding the impact of policies on misuse. The majority of the studies were judged to be of low quality based on the GRADE criteria. CONCLUSIONS: There is low to moderate quality evidence suggesting that the presence of opioid prescribing policy will reduce the amount and strength of opioid prescribed. The presence of these policies may impact the number of overdoses, but there is no clear evidence to suggest that it reduces opioid misuse.
BT - Journal of opioid management
C5 - Opioids & Substance Use; Healthcare Policy
CP - 2
CY - United States
DO - 10.5055/jom.2016.0322
IS - 2
JF - Journal of opioid management
N2 - OBJECTIVE: In response to persistent public health concerns regarding prescription opioids, many states and healthcare systems have implemented legislation and policies intended to regulate or guide opioid prescribing. The overall impact of these policies is still uncertain. The aim of this systematic review was to examine the existing evidence of provider-level and patient-level outcomes preimplementation and postimplementation of policies and legislation constructed to impact provider prescribing practices around opioid analgesics. DESIGN: A systematic search of MEDLINE, EMBASE, the Web of Science, and the Cochrane Database of Systematic Reviews was conducted to identify studies evaluating the impact of opioid prescribing policies on provider-level and patient-level outcomes. The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Eleven studies were included in the review. A meta-analysis was not possible due to between-study heterogeneity. Six of the studies assessed state-level policies, and five were at the level of the healthcare system or hospital. Studies showed temporal associations between policy implementation and reductions in opioid prescribing, as well as opioid-related overdoses. Results were mixed regarding the impact of policies on misuse. The majority of the studies were judged to be of low quality based on the GRADE criteria. CONCLUSIONS: There is low to moderate quality evidence suggesting that the presence of opioid prescribing policy will reduce the amount and strength of opioid prescribed. The presence of these policies may impact the number of overdoses, but there is no clear evidence to suggest that it reduces opioid misuse.
PP - United States
PY - 2016
SN - 1551-7489; 1551-7489
SP - 109
EP - 118
EP - 
T1 - State-level and system-level opioid prescribing policies: The impact on provider practices and overdose deaths, a systematic review
T2 - Journal of opioid management
TI - State-level and system-level opioid prescribing policies: The impact on provider practices and overdose deaths, a systematic review
U1 - Opioids & Substance Use; Healthcare Policy
U2 - 27194195
U3 - 10.5055/jom.2016.0322
VL - 12
VO - 1551-7489; 1551-7489
Y1 - 2016
ER -