Association of prescription drug monitoring program laws with bedridden and missed work days

Objective To examine the relationship between optional and must-use prescription drug monitoring programs (PDMPs) and markers of disability. Data Sources Nationwide data from the National Health Interview Survey for 2006-2015. Study Design Generalized difference-in-difference models with state-specific time trends were used to assess the relationship between PDMPs and two outcomes: missed days of work and bedridden days. Data Collection/Extraction Methods All respondents above the age of 18 years with complete data on key measures were included. A subpopulation of respondents who had a recent surgery or injury was identified. Principal Findings We found an increase of 3.3 and 5.9 bedridden days associated with optional and must-use PDMPs, respectively, for respondents reporting a recent injury or surgery (p-values <0.05; unadjusted population average 12.2 bedridden days). Increases in days of missed work were not statistically significant. Conclusions Implementation of PDMPs was associated with negative unintended consequences in the injury/surgery subpopulation. The association between bedridden days and PDMPs suggests a gap between clinical trials showing equivalence of opioids and nonopioids for pain treatment and real-world results. As increasingly tighter opioid restrictions proliferate, evidence-based strategies to address pain without opioids in the acute pain population likely need to be more widely disseminated.