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Purpose  Prescription drug monitoring programs (PDMPs) have been established to combat the opioid epidemic, but there is no data on their efficacy in children. We hypothesized that a statewide PDMP mandate would be associated with fewer opioid prescriptions in pediatric surgical patients.    Methods  Patients < 18 undergoing inguinal hernia repair, orchiopexy, orchiectomy, appendectomy, or cholecystectomy at a tertiary children’s hospital were included. The primary outcome, discharge opioid prescription, was compared for 10 months pre-PDMP ( n  = 158) to 10 months post-PDMP ( n  = 228). Interrupted time series analysis was performed to determine the effect of the PDMP on opioid prescribing.    Results  Over the 20-month study period, there was an overall decrease in the rate of opioid prescriptions per month (− 3.6% change,  p  < 0.001). On interrupted time series analysis, PDMP implementation was not associated with a significant decrease in the monthly rate of opioid prescriptions (1.27% change post-PDMP,  p  = 0.4). However, PDMP implementation was associated with a reduction in opioid prescriptions of greater than 5 days’ supply (− 2.7% per month,  p  = 0.03).    Conclusion  Opioid prescriptions declined in pediatric surgical patients over the study time period. State-wide PDMP implementation was associated with a reduction in postoperative opioid prescriptions of more than 5 days’ duration.

Impact of prescription drug monitoring program mandate on postoperative opioid prescriptions in children