A randomized clinical trial conducted by researchers from Columbia University Mailman School of Public Health and the University of Southern California found that simple reminder emails significantly increased clinicians' use of Prescription Drug Monitoring Programs (PDMPs), although opioid prescribing rates did not change during the study. The results were published in JAMA Health Forum.
PDMPs are databases that monitor the prescription of opioids and other controlled substances, with all U.S. states operating such systems. While most states require clinicians to have PDMP accounts and check them before prescribing opioids, adherence varies among healthcare providers.
In this study, researchers worked with Minnesota's state government to evaluate low-cost strategies for safer prescribing practices. They identified 7,872 physicians and physician assistants who had not met state requirements regarding PDMP usage. These clinicians were randomly assigned to receive one of two types of emails—one emphasizing legal obligations related to PDMP use and another focusing on clinical guidelines—or no email at all as a control group.
Both email interventions led to significant increases in PDMP engagement, such as account creation and patient searches, especially among those receiving messages about legal requirements. "The legal requirement emails were particularly encouraging because they led one in four clinicians to use the PDMP who otherwise would not have," said Mireille Jacobson, PhD, professor at the University of Southern California. "Although the emails did not change opioid prescribing, just getting clinicians to make PDMP accounts and check the PDMP could still translate to safer and better-informed care for patients."
The impact on PDMP use was observed for at least seven months after sending the initial emails. However, neither type of message produced measurable changes in actual opioid prescriptions.
This research builds on previous studies indicating that straightforward communication can promote greater use of monitoring programs without altering overall prescribing patterns. "Email is a low-cost, scalable intervention that meaningfully increases PDMP engagement, especially when legal requirements are emphasized," said Sacarny. "These interventions could serve as templates for efforts to promote other best practices in health care, too."
"Our approach is backed by randomized trial evidence and can be easily translated to other contexts," Sacarny added. "The results should be useful and encouraging for policymakers, health systems, and organizations focused on safer prescribing and patient safety."
Co-authors included Tatyana Avilova from Secretariat; Ian Williamson; Weston Merrick from Minnesota Management and Budget Agency; along with support from the Abdul Latif Jameel Poverty Action Lab.
