Tuesday, March 3, 2015

State-based prescription drug monitoring programs have emerged as one of the primary ways state governments have attempted to address the increasing national concern about prescription drug abuse.

These programs are databases where information on prescriptions for and use of controlled substances is collected, analyzed and reported. Physicians and pharmacists contribute and access data electronically, and because of that, the success of these programs depends largely on awareness and use of them.

A new study released on March 2, 2015, in Health Affairs reports that most primary care physicians are aware of prescription drug monitoring programs and have used the data in their practices, but do so only intermittently.

The study surveyed 420 physicians randomly identified through the American Medical Association’s Masterfile list. Of those physicians surveyed, 72 percent were aware of their state’s prescription drug monitoring program, and 53 percent reported that they had used the programs.

Beyond that, 74 percent of physicians who had used data from a prescription drug monitoring program believed that it had led them to prescribe opioids less frequently.

As of June 2014, every state except Missouri had a prescription drug monitoring program.

“The goal of these programs is to make physicians and pharmacists aware of drugs being prescribed to their patients so they can better identify potentially abusive behaviors, like doctor shopping, as well as harmful drug interactions,” said Lainie Rutkow, PhD, associate professor at the Johns Hopkins Bloomberg School of Public Health. “Our findings suggest that these goals are being met, at least to some extent.”

Unfortunately, Rutkow explained, while the physicians are aware of the programs and the programs are impacting prescribing practices, the physicians are not accessing the programs regularly.

Physicians who had used data from a prescription monitoring program reported using the program for only about eight patients in the month leading up to the survey. The physicians surveyed see an average of 285 patients per month, and reported they prescribe opioids to about 35 patients per month.

When asked about any barriers for using the data, many of the physicians noted that the data were not presented in an intuitive format, and that accessing the data was time consuming.

“Awareness of the programs doesn’t seem to be enough to promote consistent use,” said Rutkow. “Ensuring that the program data are presented in a user-friendly format and are not overly time-consuming to access would be a great start to increase use. Beyond that, integrating the program data with electronic health information systems or even establishing a legislative mandate may help promote more consistent use by physicians.”

Rutkow and the study team point to Kentucky as an example of a state that requires physicians to register and use the state’s prescription monitoring program. After Kentucky’s law was passed in 2012, registration increased from 32 percent to 83 percent, and requests for data increased more than 300 percent.

“Kentucky’s success suggests that the law could be a powerful tool to promote the use of these programs,” said Rutkow.

Lydia W. Turner, MHS, Eleanor Lucas, BA, Catherine S. Hwang, MSPH, and Caleb Alexander, MD, MS also contributed to the study.


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