Can E-mails Nudge Safer and Better-Informed Prescribing of Risky Drugs?

Drug overdose deaths have skyrocketed in recent years, and many overdoses continue to involve prescribed medications like opioids and stimulants. At the same time, state prescription drug monitoring programs (PDMPs), which help clinicians prescribe these medications safely, remain underused. In Minnesota, 32% of opioid prescriptions are written by clinicians who do not use the PDMP. In many states, including Minnesota, policymakers have limited tools to raise PDMP use even though it is often required under state law. To address this policy dilemma, we will test e-mails designed to facilitate PDMP use and evaluate their effects on PDMP querying, PDMP account-making, and the prescribing of opioids and other risky medications. Our work will include a projected 7,126 physician and physician assistant prescribers of opioids and other controlled substances who lack PDMP active accounts, never query the PDMP, or query the PDMP infrequently relative to their prescribing volume. To generate evidence on clinician motivation for responding to encouragement, we will randomly vary messaging to focus on legal requirements to use the PDMP vs. clinical benefits of the PDMP. This research builds on a multi-year collaboration with the Minnesota PDMP and is informed by evidence generated from a previous successful trial funded by J-PAL SLII.