A recent effort in Massachusetts to curb opioid prescriptions by health providers may have been ineffective, according to an opinion piece in the December 14 issue of the New England Journal of Medicine co-authored by Harvard T.H. Chan School of Public Health’s Dr. Michael Barnett. The authors argued that rapid evaluation of such public health policies could help provide clarity as to their potential benefit.
Dr. Barnett, assistant professor of health policy and management at Harvard Chan School, and co-authors wrote about what happened after the state’s public health department sent confidential letters last March to every health care provider who prescribes opioids, comparing their prescribing practices over the previous year with those of their peers. Such peer comparisons have shown promise in influencing physician behavior in the past, according to the article. The effort was a component of the state’s overall plan to work with health care providers to bring the number of opioid prescriptions down.
When the researchers analyzed prescribing behavior among 284 primary care physicians in the state in the 12 weeks after the letters were sent, they found no evidence that the physicians’ prescribing rates fell as compared with rates in other Northeast states, and no reductions in opioid prescribing among the highest-volume opioid prescribers.
Given the urgency of the opioid crisis, new initiatives to curb opioid prescribing need to be evaluated for their effectiveness in a timely fashion, the authors wrote. One possible solution, they suggested, would be to couple opioid-related policymaking with an evaluation plan that mines existing databases with real-time information on prescription drug use.
“As a researcher, I am continually amazed at the pace of policy-making that just kind of races ahead of any kind of evaluation or monitoring, even when it’s not hard to do so,” said Dr. Barnett in a December 13, 2017 Boston Globe article.
Read the NEJM Perspective article: Coupling Policymaking with Evaluation—The Case of the Opioid Crisis