Policy, Prescribing, and Clinical Practice: Lessons From Recent Evaluations in Kentucky

Policy changes may influence prescribing practices in positive ways or have unintended consequences. Research focused on understanding prescribing practices and policy impacts can inform policymakers and other stakeholders. In this session, presenters will discuss results from three such projects conducted in Kentucky. First, in 2018 Kentucky was the first state to mandate drug conviction data be made available to prescribers and pharmacists when querying the prescription drug monitoring program (PDMP). Presenters will highlight changes in perceptions captured in the post-law implementation survey and evaluations from continuing education designed to assist practitioners in interpreting drug conviction data in the context of patient care. Second, PDMP data has evolved as a critical public health surveillance data source. The Kentucky stakeholders used PDMP data to address questions on changes in access to buprenorphine treatment for opioid use disorder during the COVID-19-related closures, when Kentucky experienced a spike of drug overdose deaths. The results from this analysis triggered specific responses. Third, prescription data is extensively used in clinical care to warn prescribers that a patient may be at an increased risk for opioid overdose, and in policy and intervention evaluations thru indicators for high-risk opioid prescribing at the population level. These measures involve morphine milligram equivalent calculations that rely on prescription days supply information which may vary among pharmacists leading to inaccuracies. Presenters will share results on estimated accuracy of days supply and qualitative information collected from a representative sample of Kentucky independent pharmacies as part of a days supply validation study.