Impact Evaluation on Prescription Drug Monitoring Program Report

This report presents an impact evaluation of Prescription Drug Monitoring Programs (PDMP) aimed at mitigating opioid misuse, diversion, and mortality. The introduction outlines the health crisis stemming from opioid overconsumption and the rationale for implementing PDMPs. The report delves into the problem description, including the rising death toll and the significance of physician-prescribed opioids. It identifies the context within health and social care, emphasizing the evaluation's role in informing future policy. The study examines the components of the health policy program, including drug monitoring, disclosure, and authorized user training. The theory of change is explored, highlighting key assumptions and necessary conditions for success. Part B of the report focuses on the evaluation's outcomes, assumptions tested, and the evaluation problem. The methodology utilizes a quantitative quasi-experimental research design, specifically the difference-in-differences method, and the propensity score method for evaluating intervention effects. The report justifies the selection of these methods and discusses data sources, sensitivity analysis, and limitations. The conclusion synthesizes the findings, emphasizing the effectiveness of PDMPs in controlling opioid-related deaths and the importance of continuous evaluation for policy refinement.

Impact evaluation
on Prescription Drug
Monitoring Program

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY ..................................................................................................................................3
PROBLEM DESCRIPTION ..........................................................................................................3
Background of the health issues which requires to be address .................................................3
Identification of context that will introduced in ........................................................................4
Reason for evaluation .................................................................................................................4
DESCRIPTION OF HEALTH PROGRAM ...................................................................................4
Reason for selecting this health policy program ........................................................................4
Identification of components of health policy program ............................................................4
THEORY OF CHANGE..................................................................................................................5
Key assumptions in theory of change ........................................................................................5
Analysing the necessary conditions for achieving the success...................................................5
PART B ...........................................................................................................................................6
Outcome of evaluation................................................................................................................6
Assumption tested ......................................................................................................................6
Evaluation problem.....................................................................................................................6
Data sources................................................................................................................................7
Study design and Analysis..........................................................................................................7
Identification of the method utilized for evaluating the effect of intervention on selected
outcome.......................................................................................................................................7
Rationale for selecting the particular method for evaluation......................................................8
Identification of Sensitivity analysis utilized.............................................................................8
Method used for collecting the data which is generated during evaluation. .............................9
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10

INTRODUCTION
Prescription drug monitoring program is organised by state with the objective of
reducing Opioid related misuse, mortality as well as abuse. It has been found that the most of
the drugs which are generally misused are prescribed by physician. Implementation of programs
for preventing the misuse of drug is very much important in order to reduce the number of
deaths.
The report will highlight the background of the health issues which are required to be
addressed. It will have focus on identification of different components of health policy
program. Study emphasizes on evaluating the effect of prescription drugs monitoring program.
MAIN BODY
PROBLEM DESCRIPTION
The main problem is increase in number of deaths due to overconsumption of opioid.
Background of the health issues which requires to be address
Increase in number of deaths due to over dosage or misuse of opioid.. It is the health
issues for controlling which quick measures are required to be implemented. According to
national survey report on the topic Usage of drug as well as health, result of which reveals that
non medical utilization of opioid is second only to marijuana in relation to illicit usage of
substance. There are many people in United states are non medically utilizing the opioid. There
has been continuous rise in death rate due to opioid. As per the national survey report, there has
been death of approx. 47055 people due to overconsumption of opioid (Yarbrough, 2018). The
result of the research conducted by national authority also reveals that the sixty percent of death
has been caused due to prescription of opioid by medical professionals. The increase in number
of deaths due to the over dosage of Opioid has become quite serious concern. Many of the state
has executed the electronic prescription monitoring program for tracking the schedule medical
dispensed from medical professional or pharmacists (Pauly, Freeman and Talbert, 2018).
Therefore, the main purpose of the prescription drug monitoring is to ensure that right amount of
prescription are given to patients and to control the sale of drugs.

Identification of context that will introduced in
The aim of the topic that is evaluating the effect of Prescription Drug Monitoring
Program will be executed in context of health and social care. The scope of particular
investigation include the proof related to the effect of electronic prescription drug monitoring
program In United States. The conceptual hypothesis or framework can be utilized for informing
the implementation of prescription drug monitoring policy program in the future.
Reason for evaluation
The evaluation of the Prescription Drug Monitoring Program is very much important in
order to analyse its implication in terms of reducing the death rate due to the overconsumption of
opioid. Main reason for evaluating the Prescription Drug Monitoring Program is to identify the
need to make changes in policy related to health and social care. One of the rationale of
evaluation is to identify the costs as well as advantages of Prescription Drug Monitoring Program
on users.
DESCRIPTION OF HEALTH PROGRAM
Reason for selecting this health policy program
The main rationale for selecting the specific topic is to evaluate the effect of the health
policy. In addition to this, researcher by executing the investigation on specific subject intends to
measure the effectiveness of the health program in terms of controlling the death due to
consumptions of opioid. In addition to this, investigator want to identify the need of changes
which are required to made in the health policy program in order to make it effective for
controlling the deaths due to opioid (Winstanley, McNamee and MacKinnon, 2018.). In addition
to this, other rationale for evaluation is to measure the direct as well as indirect effect of
Prescription Drug Monitoring Program on abuse.
Identification of components of health policy program
Prescription drugs monitoring program is basically organized by state government for
collecting as well as distributing information related to the prescription of controlled substances
that re managed by different state agencies. The different components of Prescription drugs
monitoring program are :
Drug monitoring: such medications are required to be monitored which have high potential of
abuse and also involves such substances which are required to be controlled.

Disclosure: It includes the detailed information about the legislations, occupational licensing
which are required to be obtained by pharmacists or medical professional for selling the drugs
which consists of such substance that are required to be controlled.
De-identified information: Medical professional or pharmacists are required to provide all
essential information about the medicine to patient.
Authorized users: The data gathered during the Prescription Drug Monitoring Program could
be utilised by health licensing agencies, protectorial officials, dispensers etc. for enhancing the
patient care or safety.
Authorize users training and education: As per this component, the all authorize users
accessing the information required to prove that they are educated and trained for utilizing the
PDMP information in appropriate manner (Buchmueller and Carey, 2018).
Standard of procedure for access and utilization of Information: It provides the standards for
utilising the specific medicine for decreasing the abuse as well as inappropriate utilization of
system.
Confidentiality protection: It highlights the code of conducts as well as provide detail about for
penalties which are required to be paid by an individual in case of failure to maintain the
confidentiality of data.
THEORY OF CHANGE
Key assumptions in theory of change
The change theory is based on the belief that An effective health prescription drug
monitoring program can assist in bringing the positive change in the behaviour of prescribers that
is pharmacists or medical professionals. The other belief is that the health prescription drug
monitoring program will lead to the new trends in relation to consumption of Opioid.
Analysing the necessary conditions for achieving the success
The increase in death due to the over dosage of the Opioid is considered to be a issue of
high concern. Quick as well as proper measures are required to be taken in order to deal with
such type of issues. There is very much requirement of educating people about the consequences
of over consuming the as specific drug. The different types of medical campaign can be
organized by medical professional or government for making public aware about the
consequences of over dosage Opioid (Nadeau, Wagner and Tu, 2018.). In addition to this, in

order to get success by implementing the Prescription Drug Monitoring Program there are
basically following requirements these are education, funding, technology , security as well as A
cess.
PART B
Outcome of evaluation
The evidence of effect of prescription drug monitoring program as an opioid mitigation
technique has remain mixed. Sensitivity analysis revealed the four important aspects of opioid
related results that are identified in the present study on measuring the effectiveness of
prescription drug monitoring program on the issue related to overconsumption of the opioid. The
four main dimensions which has been found during the investigation is that prescription drug
monitoring program has significant effect on the opioid prescribing; opioid diversion and supply;
opioid misuse; and opioid-related morbidity and mortality. In simple words, implementation of
prescription drug monitoring policy has proven to be effective in relation tpo controlling the
number of death due to over dosage of Opioid.
Assumption tested
The assumption which has been tested is that prescription drug monitoring program will
lead to the decrease in number of death due to opioid. It has also been believed that execution
policy which prove helpful in bringing the change in the attitude of prescribers and also people
who consume specific drug, PROPENSITY SCORE test is basically a two-step procedure during
which the logistics regression model is designed for predicting the probability of influence on
the way treatement are provided to patients.
Evaluation problem
The main problem on which investigation has been performed is related to the increase
in the number of death due to overconsumption of drugs. It is the issue of high concern and an
effective measure are required to be taken as soon as possible to deal with the same.

Data sources
Both Primary and secondary sources has been utilized by researcher for gathering the
facts as well as figures related to measuring the effectiveness of prescription drug monitoring
program in term of controlling the number of death due to overconsumption of opioid. Both the
sources has been used by investigation as to gather huge amount of information related to the
topic. Investigator has collected the huge amount of information ,as it will assist them in
developing the understanding about the issue. In addition to this, data gathered from both
primary and secondary sources will assist researcher in making the suitable decision. It will also
help investigator in identification of the suitable measures which can be taken to control the
number of death due to the over dosage of Opioid.
Study design and Analysis
Researcher has utilized the Quantitative Quasi experimental research design that is
difference in difference (DID) for conducting the investigation for identifying the effectiveness
of drug monitoring program in context of controlling the number of death due to
overconsumption of Opioid.
Identification of the method utilized for evaluating the effect of intervention on selected outcome
Investigator has used the PROPENSITY SCORE method for evaluating the effect of
intervention on selected outcomes. It is the method of equating group at baseline. The
PROPENSITY SCORE method has been utilized by investigator for evaluating the impact of
intervention on selected outcome as it enables investigator to eliminate the biases in relation to
the choice of treatment while utilize observational information for determining the casual
treatment effects. PROPENSITY SCORE is the method which mainly emphasizes on the
relationship between results of characteristics of patients as well as primary treatment (Soelberg,
Berkeley and Brown Jr, 2018). The assumption which has been made during the PROPENSITY
SCORE test is that the participants chosen for the investigation procedure would have prescribed
the Opioid drugs to the patient. The rationale for selecting the PROPENSITY SCORE over
other test is that Statistical adjustments utilising approximation propensity score have the
beneficial property of balancing ascertained covariates that were utilised for constructing the
score, thus producing a situation closer to actual randomization. In addition to this, other
rationale for selecting a specific test is that it is the method which can be utilized outside model
based approach for making comparison between patients with similar characteristics. In addition

to this, other advantages of using the PROPENSITY SCORE is that it sum up all measured co-
founders in the single score. It also provides researcher an ease in matching as well as comparing
the PROPENSITY SCORE
The biggest limitation of the PROPENSITY SCORE method is that no measures are
taken to balance the unbalance characteristics. Other limitation is that there are high chances of
biases in the outcomes.
Rationale for selecting the particular method for evaluation
Investigator has selected the Quasi experimental design over synthetic model, regression
etc. The researcher has utilized the specific research design as it is more feasible. In addition to
this, investigator perceives that reactions to the test subjects are more genuine as investigation is
conducted in natural setting. The main advantages of using the Quantitative Quasi experimental
research design is that it helps researcher in analysing general trends from the outcomes (Rossi,
Lipsey and Henry, 2018).
The biggest limitation of difference in difference method is that it does not enable
comparison. In addition to this, other major weakness of Quantitative quasi experimental design
is that it only involves single study group. Researcher is required to be more conscious as well as
careful while interpreting the outcomes.
Identification of Sensitivity analysis utilized
Sensitivity analysis is also recognized to be as simulation analysis. It can be defined as
technique which is utilized for determining the result under a given range of variables.
Sensitivity analysis assists researcher in analysing the way changes in one variable have impact
on results, In context of present study, Correlation is the sensitivity analysis which has been
applied by researcher in present study. The rationale for which investigator has selected the
specific method is that it assist in defining the relation between independent and dependent
variables (Keith, Shannon and Kulich, 2018. ).
Technique utilize for ensuring the internal validity of data.
Internal validity can be defined as the way experiment has been performed. It is basically
the concept in research which reflects whether the outcome drawn from investigation process are
trustworthy as well as meaningful. Researcher has utilized the time varying treatment effect as

well as has conducted the balancing test in order to analyse the changes in composition. In
relation to the present investigations , researcher has applied the time series design for ensuring
the internal validity of outcomes drawn from the investigation procedure. In time series method,
set of measurement are taken at regular interval of time in order to ensure high validity of data.
Method used for collecting the data which is generated during evaluation.
Interview is the technique which is used by investigator for collecting the data related to
the topic. Investigator by applying the random sampling technique has selected the six
pharmacists as well as 5 prescribers as participants in the investigation process. Researcher has
designed the questions keeping in mind the objective of study. Closes ended questions has been
asked by researcher., specific technique has been applied as investigator perceives that it will
assist them in getting the relevant answers to their questions (Hunt, Zyzanski and Werner,
2019). In addition to this, some amount of information has also been gathered through secondary
sources such as by using the books, Journals Online articles etc. The questionnaire method has
been chosen for collecting the data related to the topic as it is less costly and less expensive as
compared to other techniques of data collection.
CONCLUSION
It has been concluded from the report that the prescription drug monitoring policy which
has been implemented has proven to be effective in reducing the number of deaths due to over
dosage of Opoid. The other fact which has been discovered is that the policy which has been
implemented has Significant influence morality, morbidity, pattern of consumption of Opioid
and medical prescription. It has been concluded that the different models which has been used
during the investigation has assisted the researcher in measuring the effectiveness of PDMP
policy and has assisted investigator in identification of strength or weaknesses in the literature.
The suggestion is that there is great requirement to generate awareness about the
consequences of taking the over dosage of Opioid. Both government and medical professional
required to take combine initiatives for spreading the information related to the harmful effect of
taking the over dosage of specific drugs, as this tactic will assist in dealing with specific issue in
effective manner.

REFERENCES
Books and Journals:
Buchmueller, T.C. and Carey, C., 2018. The effect of prescription drug monitoring programs on
opioid utilization in medicare. American Economic Journal: Economic Poli.10(1). pp.77-
112.
Nadeau, R.,Wagner, C. and Tu, H., 2018. Addressing the opioid epidemic: impact of opioid
prescribing protocol at the University of Minnesota School of
Dentistry. Craniomaxillofacial trauma & reconstructio. 11(02.pp.104-110.
Winstanley, E.L., McNamee, C. and MacKinnon, N.J., 2018. Mandatory review of a prescription
drug monitoring program and impact on opioid and benzodiazepine dispensing. Drug and
alcohol dependence. 188. pp.169-174.
Pauly, N.J., Freeman, PR. and Talbert, J., 2018. Features of prescription drug monitoring
programs associated with reduced rates of prescription opioid-related poisonings. Drug
and alcohol dependenc. 184 pp.26-32.
Yarbrough, C.R., 2018. Prescription drug monitoring programs produce a limited impact on
painkiller prescribing in Medicare Part D. Health services research. 53(2). pp.671-689.
Soelberg, C.D., Chou, R., Ramachandran, B.K., Berkeley, A. and Brown Jr, R.E., 2018. The
Food and Drug Administration Should Mandate Risk Evaluation and Mitigation Strategies
Training for All Opioids. Anesthesia & Analgesia, 126(4), pp.1413-1417.
Rossi, P.H., Lipsey, M.W. and Henry, G.T., 2018. Evaluation: A systematic approach. Sage
publications.
Keith, D.A., Shannon, T.A. and Kulich, R., 2018. The prescription monitoring program data:
what it can tell you. The Journal of the American Dental Association, 149(4), pp.266-272.
Hunt, A.W., Zyzanski, S. and Werner, J.J., 2019. Characteristics and Red Flag Correlates of
Psychiatric Outpatients in a Mandated-Use Prescription Drug Monitoring Program State:
A PBRN Card Study. Addictive Disorders & Their Treatment, 18(1), pp.36-43.