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Identifying Persistent Opioid Use After Surgery: The Reliability of Pharmacy Dispensation Databases.
- Anne C Fernandez, Amy Bohnert, Vidhya Gunaseelan, Mehrdad Motamed, Jennifer F Waljee, and Chad M Brummett.
- Department of Psychiatry, Addiction Center, University of Michigan Medical School, Ann Arbor, MI.
- Ann. Surg. 2023 Jul 1; 278 (1): e20e26e20-e26.
ObjectiveThe present study assessed concordance in perioperative opioid fulfillment data between Michigan's prescription drug monitoring program (PDMP) and a national pharmacy prescription database.BackgroundPDMPs and pharmacy dispensation databases are widely utilized, yet no research has compared their opioid fulfilment data postoperatively.MethodsThis retrospective study included participants (N=19,823) from 2 registry studies at Michigan Medicine between July 1, 2016, and February 7, 2019. We assessed the concordance of opioid prescription fulfilment between the Michigan PDMP and a national pharmacy prescription database (Surescripts). The primary outcome was concordance of opioid fill data in the 91 to 180 days after surgical discharge, a time period frequently used to define persistent opioid use. Secondary outcomes included concordance of opioid dose and number of prescriptions fulfilled. Multinomial logistic regression analysis examined concordance across key subgroups.ResultsIn total, 3076 participants had ≥1 opioid fulfillments 91 to 180 days after discharge, with 1489 (49%) documented in PDMP only, 243 (8%) in Surescripts only, and 1332 (43%) in both databases. Among participants with fulfillments in both databases, there were differences in the number (n=239; 18%) and dose (n=227; 17%). The PDMP database was more likely to capture fulfillment among younger and publicly insured participants, while Surescripts was more likely to capture fulfillment from counties bordering neighboring states. The prevalence of persistent opioid use was 10.7% using PDMP data, 5.5% using Surescripts data only, and 11.7% using both data resources.ConclusionsThe state PDMP appears reliable for detecting opioid fulfillment after surgery, detecting 2 times more patients with persistent opioid use compared with Surescripts.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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