Unless Mandated, Physicians and Pharmacists Use Prescription Drug Monitoring Programs (PDMPs) Only Sporadically

New study investigates how healthcare professionals use PDMPs to make decisions about prescription opioids

November 27, 2018

RESEARCH TRIANGLE PARK—Prescription opioids play a key role in fueling the opioid epidemic. In a new study, 48 primary care physicians and 60 pharmacists were interviewed about how they use PDMPs—online systems that track when patients receive controlled prescription drugs, including opioids, and help uncover instances of misuse or diversion.

In most cases, physicians and pharmacists used PDMPs only sporadically. They described PDMPs as useful tools for identifying misuse and diversion of prescription opioids, but consistent voluntary use of PDMPs was limited.

Analysis of the interviews showed that physicians and pharmacists use PDMPs more in states like Kentucky, where legislation mandates that PDMPs be checked in certain circumstances. Also, pharmacists working in corporate chain pharmacies checked PDMPs more frequently because corporate policies require more routine use.

“A lot of the professionals we interviewed told us that they checked the PDMP in response to ‘red flags,’” said Mark Edlund, MD/PhD, one of the report’s co-authors. “These might include a request from a new and unfamiliar patient, being asked to fill a lost prescription, or refill a prescription early. Many interviewees said they would check the PDMP more often if it were quicker and easier to use.”

Among the areas that study participants identified for improvement were calls for more seamless integration into existing workflow and systems, like electronic health records. Some study participants described using PDMPs as “clunky” or “slow” while also acknowledging their usefulness. In addition, interviewees felt that because most PDMPs contain only state- or region-wide data, the ability to catch people with multiple prescriptions across state lines was limited.

In general, pharmacists and physicians find PDMPs to be an invaluable tool. However, results also suggest that improvements could be made to increase the frequency with which physicians and prescribers use PDMPs to make decisions. Increased consultation of PDMPs by prescribers and pharmacists could help control the misuse and diversion of prescription opioids.

This publication is the second based on a National Institute on Drug Abuse–funded study that interviewed primary care physicians—who, as a whole, write nearly half of all opioid prescriptions in the U.S.—and pharmacists responsible for dispensing those prescriptions to patients. Results of the first study are published here.