Do Must-Access Prescription Drug Monitoring Programs (PDMPs) Affect Pain and Impairment Outcomes in Older Adults?

State policies requiring clinicians to review prescription drug monitoring program (PDMP) databases have proliferated. However, patient advocates suggest these policies may adversely affect patients with chronic pain. This study aimed to quantify the effect of must-access PDMP implementation on pain and physical impairment. Using panel data on 34,431 older adults from the Health and Retirement Study (2002-2021), we conducted a heterogeneity-robust difference-in-differences analysis. Must-access PDMPs were associated with a 1.65 (95% CI: 0.43 to 2.87) percentage point increase in frequent pain during the two-year window surrounding policy implementation and a peak 3.52 (95% CI: 0.88 to 6.16) percentage point increase in the second post-policy period, after which the effect dissipated. Effects on impairment outcomes were positive but statistically insignificant. Findings suggest that must-access PDMP policies may increase numbers of older adults reporting frequent pain in the early policy implementation years, though they were not associated with statistically detectable changes in physical impairment.