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Understanding Variations in Clinician Responses to Prescription Drug Monitoring Program Mandates: A Secondary Data Analysis of National Medicaid Claims Data

Award Number: R21DA063771
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/15/2026
PERIOD OF PERFORMANCE END DATE: 07/31/2028

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Understanding Variations in Clinician Responses to Prescription Drug Monitoring Program Mandates: A Secondary Data Analysis of National Medicaid Claims Data - The widespread adoption of opioid guidelines and policies has dramatically reduced opioid prescribing and overdose deaths involving prescription opioids in the past decade. Concerns have arisen these measures may be interpreted differently across clinicians and clinical settings, potentially leading to unintended patient harms such as undertreated pain in some patients. Both the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) have issued warnings regarding the misapplication of opioid prescribing guidelines to severe pain conditions that warrant opioid use, as well as the risks associated with abrupt discontinuation or rapid tapering of opioid prescriptions. Since opioid regulations primarily target clinician’s prescribing practice, understanding how individual clinicians adopt these measures will provide a crucial first step to identify if there are unintended harms and where they might arise. Given the substantial variability in healthcare practices among clinicians and the rapid proliferation of guidelines, regulations, and policies, navigating the complexities of opioid prescribing can be challenging for clinicians, leading to inconsistencies that may not align with intended regulation goals. We propose this study to examine the variation in clinicians’ responses to the Prescription Drug Monitoring Program (PDMP) mandates, specifically focusing on emergency department (ED), urgent care, and primary care clinicians. The specific aims are: 1) Examine the association between PDMP mandates and opioid prescribing practices across different clinician characteristics; and 2) Assess the association between PDMP mandates and opioid prescribing for various pain conditions based on opioid appropriateness. We will use the Transformed Medicaid Statistical Information System (T-MSIS) Analytical File (TAF), a comprehensive dataset that contains nationwide Medicaid claims and eligibility data, we will conduct rigorous secondary data analysis to achieve the study aims. The findings from this research will be a first step to help clinicians to better adapt their responses to PDMP mandates and opioid prescribing practices to align with the regulation goals. This research examines variations in how Emergency Department (ED), urgent care, and primary care clinicians changed opioid prescribing practices in response to Prescription Drug Monitoring Program (PDMP) mandates. We will conduct rigorous secondary data analysis to achieve the study aims by building quasi-experimental econometric models using the national Medicaid claims database. Study findings will improve scientific understanding of variation in clinician responses to PDMP mandates across healthcare settings and patient populations.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $409,750 )
2026	2026	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH STREET	BIRMINGHAM	AL	35294	JEFFERSON	USA	Drug Use and Addiction Research Programs	000	1	8/7/2026	NEW	$409,750
														Subtotal = $409,750

Grand Total All Awards = $409,750

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Understanding Variations in Clinician Responses to Prescription Drug Monitoring Program Mandates: A Secondary Data Analysis of National Medicaid Claims Data

Award Number: R21DA063771

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/15/2026

PERIOD OF PERFORMANCE END DATE: 07/31/2028

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