Study: Massachusetts’ effort to influence physician opioid prescribing failed

Hydrocodone opioid pills
Amid the rush to reverse the country's opioid epidemic, policymakers shouldn't skimp on evaluating whether programs actually work. (Getty/smartstock)

Given the gravity of the country’s opioid epidemic, it’s no wonder that lawmakers and health officials hope to get doctors to prescribe fewer of the addictive painkillers.

But an effort in Massachusetts to influence prescribers was ineffective, according to an opinion piece in the New England Journal of Medicine.

The researchers reported on an effort by the state's health department, which emailed confidential reports to every healthcare provider in the state who prescribes controlled substances, comparing his or her prescribing patterns to those of peers.

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The reports included the number of opioid prescriptions a provider wrote and the total volume of opioids prescribed in the previous year, as well as the mean and median rates for other clinicians in the same specialty.

However, in the 12 weeks after the letter was sent, an analysis of 284 primary care physicians found no change in their prescribing patterns compared to doctors in other states who did not receive letters.

In October, President Donald Trump officially declared the opioid epidemic a national public health emergency under federal law. While the opioid crisis requires the swift creation of decisive policies to promote the safe use of opioids and prevent overdose deaths, those policymakers must evaluate new programs to ensure that ineffective policies are not pursued, the researchers argued.

The opinion piece called for collaborations among state governments, data providers, researchers and public health officials to figure out what does work.

One tactic that's shown promise: doctors educating patients about the dangers of misusing opioids. A poll by the Medical Group Management Association last month found that 61% of 1,029 respondents said they offer patient education on opioid misuse. Only 12% of respondents said they don’t take that step. Another 27% said their organization does not prescribe narcotics.

Most of the providers who do educate patients said they rely on face-to-face education; others combine that with printed materials or email communications, the MGMA said.

Education for prescribers is also a top priority. A commission tasked by the president to address the country’s opioid epidemic recommended that clinicians who prescribe opioids receive training on safe prescribing before they can renew their licenses with the Drug Enforcement Administration.

A federal report released this fall estimated that 11.8 million people—about 4.4% of the U.S. population—misused opioids in 2016. 

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