How long does the law allow PDMP data to be stored by the administering agency: No time frame specified. Refer the law to discussing alternatives to opioid treatment: Yes Are pain clinic physicians required to be registered with the PDMP: Yes.
11 Does the law require clinic sites to keep patient records: 7 years
Provision combinations identified as predictive of high-dispensing counties by random forest analysis, 2006-2016
27 If PDMP data the law gives dispensers access to: Potential patients >How often to. 21 If PDMP data is granted by law, dispensers have access to: Previous patients >What is the owner.
21 Whose PDMP data does the law allow dispensers to access: Former patients >What are the owner
Provision combinations identified as predictive of high-dose dispensing counties by random forest analysis, 2006-2016
Pain Management Clinic What is the Pain Clinic Doctor Requirements: No previous convictions Pain Management Clinic What is the Pain Clinic Doctor Requirements: Physically present at clinic. Pain Management Clinic What is the maximum supply of medication that doctors can dispense: Other Initial prescription opioid.
25 Initial prescription opioid
Provisions excluded from LASSO high dispensing models in the heroin phase, 2010-2012 Provision category Provision
Initial Prescription Limits for Opioid Which substances are specified in the original prescription limit: Opioids only Initial Prescription Limits for Opioid Which substances are specified in the Initial Prescription Limit: Other Initial Prescription Limits for Opioid Which substances are specified in the Initial Prescription Limit: Schedule III Initial Prescription Opioid Limits Which substances is specified in the original prescription limit: Schedule IV. Pain Management Clinic What criteria are used to determine whether a practice is subject to the PMC Act: Practice directly dispenses opioids. Pain treatment clinic What criteria are used to determine whether a practice is subject to the PMC Act: The practice treats pain patients The pain clinic What are the requirements of the pain clinic's doctors: Certification in pain treatment.
PDMP Access Which Professionals Have Access to the PDMP Data: None Initial Prescription Opioid Limits Are Exceptions to the Initial Prescription Limit Allowed: Minors Opioid Initial Prescription Limits Are Exceptions to the Initial Prescription Limit Allowed: Cancer Initial Opioid Prescription Limits Exceptions to the Initial Prescription Allowed limit: Chronic pain Initial prescribing limits for opioid Are exceptions to the original prescribing limit allowed: Hospice Initial prescribing limits for opioid Are exceptions to the original prescribing limit allowed: Other. Opioid Initial Prescribing Limits Are Exceptions to the Original Prescribing Limit Allowed: Professional Judgment Opioid Initial Prescribing Limits Are Exceptions to the Original Prescribing Limit Allowed: Substance Use Disorder Opioid Initial Prescribing Limits Is There an Initial Prescribing Limit Act: 7 days. Initial prescription limits for opioid Which substances are specified in the original prescription limit: Schedule III Initial prescription limits for opioid Which substances are specified in the original prescription limit: Schedule IV.
Supply excluded from LASSO high-dose dispensing models in the prescription opioid phase Supply category Supply.
Provisions excluded from LASSO high-dose dispensing models in the prescription opioid phase, 2006-2009 Provision category Provision
29 Pain management clinic Are there penalties for noncompliance: Criminal penalties
Provisions excluded from LASSO high-dose dispensing models in the fentanyl phase, 2013-2016
PDMP access If PDMP data the law allows dispensers to access: No PDMP access What professionals have access to PDMP data: None. PDMP access If PDMP data the law allows prescribers to access: No PDMP access Which professionals have access to PDMP data: None. PDMP report Which drug forms must be reported to the PDMP: Specify form V 0.43.
PDMP administrator Does the law require PDMP to have an advisory/supervisory board: Yes -0.61. PDMP Report Which drug programs must be reported to the PDMP: Not specified -0.58. PDMP administrator Does the law require PDMP to have an advisory/supervisory board: Yes 0.79.
PDMP Report Which drug schedules must be reported to the PDMP: Federal Schedule I 0.32. PDMP Report Which drug schedules must be reported to the PDMP: State Schedule V 0.13. PDMP Report Does the state require dispensers to check the PDMP before dispensing: New patients only -0.5 PDMP administrator How long does the law allow PDMP data to be stored by the administrative agency: between 2 and 5 years -0 ,5.
39 PDMP Report Does the law impose restrictions on interstate sharing: Receiving state must allow reciprocity with this state -1.16
LASSO coefficients, high-dose dispensing, prescription opioid phase (2006-2009), primary analysis
PDMP Access Does the law allow out-of-state law enforcement to access PDMP data: Active investigations 0.34 PDMP Admin Does the law require or permit PDMP to release de-identified data for research or education: Yes 0.29 PDMP Admin Becomes the PDMP allowed to report suspicious or statistically excessive prescribing, dispensing or purchasing. Pain Management Clinic Does the law require a medical director to be physically present at the pain clinic: Yes -0.01. PDMP Admin Requires the law of the PDMP to have an advisory/supervisory board: Yes -0.02.
What criteria are used to determine whether a practice is subject to the PMC Act: Specific percentage of patients. PDMP Access The law allows law enforcement in the state to access PDMP data: Subpoena -0.07. PDMP Admin How long does the law allow PDMP data to be stored by the administering agency: 5 years or more -0.09 PDMP Access.
Does law allow out-of-state law enforcement to access PDMP data: Warrant, court finding. PDMP custodian How long the law allows an administrative body to keep PDMP data: Between 2 to 5 years -0.32 Access to PDMP Does the law allow law enforcement agencies in the country to access PDMP data: No limit -0.33. PDMP Report How often dispensers must report PDMP data: Every 28 days or more -0.47.
LASSO coefficients, high-dose dispensing, heroin phase (2010-2012), primary analysis
43 PDMP Admin Is the PDMP permitted to report suspicious or statistically outlying prescribing, dispensing or
LASSO coefficients, high-dose dispensing, fentanyl phase (2013-2016), primary analysis
Pain Management Clinic Does the law require pain management certification: Annual 0.14 Pain Management Clinic Does the law require pain management certification: Every 3 years 0.33 Pain Management Clinic Does the law require a medical director to be physically pain clinic present: Yes 0.08 Pain Management Clinic What are the pain clinic physician requirements: No prior felony convictions 0.04 Pain Management Clinic What are the pain clinic physician requirements: No related felonies with prescription drugs or. Pain Management Clinic What criteria are used to determine if a practice is subject to the PMC Act: The specific percentage of. Pain Management Clinic What criteria are used to determine if a practice is subject to the PMC Act: The practice advertises as a pain clinic.
45 Pain Management Clinic Does the law require PMC sites to keep patient records: 5 years -0.38
PDMP Access To whose PDMP data prescribers have access by law: Potential patients 1.04 PDMP access To whose PDMP data prescribers have access by law: Current patients -0.1 PDMP access To whose PDMP data physicians have access by law: potential patients 0.01 PDMP Access To whose PDMP data dispensers have access by law: former patients 2.03. PDMP Access Does the law allow state law enforcement to access PDMP data: No restrictions -1.74 PDMP Access Does the law allow state law enforcement to access PDMP data: Subpoena 0.49 PDMP- access Does the law allow out-of-state law enforcement to access PDMP data: warrant, court finding of. PDMP Report How often should dispensers report data to the PDMP: Between 8 and 27 days 0.23 PDMP Report Which drug schedules must be reported to the PDMP: State Schedule I -0.34 PDMP Report Which drug schedules must be reported to the PDMP reported : State Schedule V 0.05 PDMP report Which drug schedules must be reported to the PDMP: Federal Schedule I -0.48 PDMP report Which drug schedules must be reported to the PDMP: Federal Schedule V 0.29 PDMP report Which drug schedules must be reported are reported to the PDMP: Not specified -0.96 PDMP report Does the state require prescribers to check the PDMP before prescribing: New patients only -1.66 PDMP report Does the state require prescribers to check the PDMP before prescribing prescribing: Chronic pain patients -0.6 PDMP report State requires prescribers to check PDMP before prescribing: Every patient, every time 1.63 PDMP report State requires dispensers to check PDMP before dispensing: New patients only 0.05 PDMP Report Does the state require dispensers to check the PDMP before dispensing: Chronic pain patients -0.85.
PDMP Report Does the law allow the PDMP to share data with other state PDMPs: Yes -0.24. 47 PDMP Report Does the law impose restrictions on sharing between states: Receiving state must allow reciprocity with this.
47 PDMP Report Does the law impose restrictions on interstate sharing: Receiving state must allow reciprocity with this
One-year sensitivity analysis results showing rank-order significance of the top 20 predictors of high opioid dispensing and high-dose dispensing in the prescription opioid phase, 2006–2009. 1-year sensitivity analysis results showing ranked importance of the top 20 predictors of high opioid dispensing and high eFigure 5. 1-year sensitivity analysis results showing ranked importance of top 20 predictors of high opioid dispensing and high-dose dispensing in the heroin phase, 2010–2012.
The results of a one-year sensitivity analysis demonstrate the ranked importance of the top 20 predictors of high opioid dispensing and high dose dispensing in the fentanyl phase, 2013-2016. Results from a six-month coding sensitivity analysis show the ranked importance of the top 20 predictors of high opioid dispensing.
51 eFigure 7. Six-month coding sensitivity analysis results displaying ranked importance of the top 20 predictors of high opioid dispensing and
53 eFigure 9. Six-month coding sensitivity analysis results displaying ranked importance of the top 20 predictors of high opioid dispensing and
Results of sensitivity analysis of the retained test set showing the ranked significance of the top 20 predictors of high opioid dispensing and high-dose dispensing in the prescription opioid phase, 2006–2009. Results of the sensitivity analysis of the retained test set displaying the ranked significance of the top 20 predictors of high opioid distribution and.
55 eFigure 11. Held-out test set sensitivity analysis results displaying ranked importance of the top 20 predictors of high opioid dispensing and
Withheld test set sensitivity analysis results showing the importance of the top 20 predictors of high opioid prescription and high-dose dispensing in the fentanyl phase, 2013-2016. Random forest leaving out LASSO sensitivity analysis results showing the importance of the top 20 predictors of high opioid.
57 eFigure 13. Random forest omitting LASSO sensitivity analysis results displaying ranked importance of the top 20 predictors of high opioid
59 eFigure 15. Random forest omitting LASSO sensitivity analysis results displaying ranked importance of the top 20 predictors of high opioid
The results of the LASSO interaction sensitivity analysis show the ranked importance of the top 20 predictors of high opioid dispensing and high dose dispensing in the prescription opioid phase, 2006–2009. The results of the LASSO interaction sensitivity analysis show the ranked importance of the top 20 predictors of high opioid dispensing.
61 eFigure 17. LASSO interactions sensitivity analysis results displaying ranked importance of the top 20 predictors of high opioid dispensing
- Model performance, high dispensing, single-year sensitivity analysis Variables tried
- Model performance, high dispensing, held out test set sensitivity analysis Variables tried
- Model performance, high dispensing, LASSO interactions sensitivity analysis Variables tried
- Model performance, high-dose dispensing, single-year, sensitivity analysis Variables
- Model performance, high-dose dispensing, held out test set, sensitivity analysis Variables
- Model performance, high-dose dispensing, random forest omitting LASSO, sensitivity analysis Variables
Results of a sensitivity analysis of LASSO interactions showing the ranked significance of the top 20 predictors of high-volume opioid dispensing and high-dose fentanyl phase, 2013–2016. OOB: Out-of-Bag Error; CI: confidence interval; PPV: Positive predictive value; NPV: Negative predictive value. OOB: Out-of-Bag Error; CI: confidence interval; PPV: Positive predictive value; NPV: Negative predictive value.
