Here is an example of the Board of Medical Examiners using PDMP history in the complaint process resulting in the practice shutting down. The record of PDMP checks is there, and a few states are starting to look at their mandated use requirements and the gaps between prescriptions written and PDMP checks done.
This transactional history is part of the state PDMP and can be used now or much later to support complaints.
How do you show your compliance to mandated use?
Attention to patterns of prescription requests and the prescribing of opioids as part of an ongoing relationship between a patient and a healthcare provider can decrease the risk of diversion. Periodic review of state PDMP, where available, is also a useful tool to monitor compliance. Evaluation should initially include…a drug history… Documentation is essential.
The CDC advises providers to use PDMPs… States should consider ways to increase their use … available real-time, and alerts to prescribers.
In 2012, both New York and Tennessee required prescribers to check their state’s PDMP before prescribing painkillers.
The results one year later: New York realized a 75% drop and Tennessee a 36% drop in patients who were seeing multiple prescribers to obtain the same drugs.
The use of PDMPs…is helping to reduce misuse of prescription drugs.
Emergency Physicians must balance under-treatment of pain with concerns about drug diversion and doctor shopping. Use of a state PDMP may help identify patients who are at high risk for prescription opioid diversion or doctor shopping… To quantify the effects of PDMPs, studies were conducted of ED providers who cared for adult patients with pain. Of the patients with complete data in one study, information from the state’s PDMP System altered prescribing practice in 41%. Knowledge of the i…
PDMPs have many limitations in their current format, including complex access issues, timeliness, and whether the data are presented to the physician automatically or require physician effort to retrieve.
Prescription drug monitoring programs (PDMPs) are now active in most states to assist clinicians in identifying potential controlled drug misuse, diversion, or excessive prescribing. Little is still known about the ways in which they are incorporated into workflow and clinical decision making, what barriers continue to exist, and how clinicians are sharing PDMP results with their patients.
Design Qualitative data were collected through online focus groups and telephone interviews.
S…
What prescribers can do to safely and effectively use opioids for CNCP (includes the following)
- Screen for prior or current substance abuse/misuse
- Do not use concomitant sedative–hypnotics or benzodiazepines
- Track daily MED using an online dosing calculator
- Use the state Prescription Drug Monitoring Program to monitor all sources of controlled substances
The AAOS recommends the following tools, which have been shown to significantly reduce medication errors:
- computerized physician order entry
- computerized decision support systems
- computerized monitoring of adverse drug events
- pharmacist-assisted rounds
- high-risk drug protocols
Overdose deaths are “just the tip of the iceberg”: that for every death there are many more hospital treatment admissions, emergency room visits, people who abuse or are dependent on prescripti…
Prescribing or dispensing to an abuser, diverter, misuser or ‘doctor shopper’ puts the provider, their practice and or institution, as well as the patients at high risk.
Although relieving pain and reducing suffering are primary emergency physician responsibilities, there is a concurrent duty to limit the personal and societal harm that can result from prescription drug misuse and abuse.
Thirteen multi-state PDMP projects were sponsored in 2012-13. While providers indicated that PDMPs gave them more confidence for prescribing pain medication, the study concluded that the easier the data is to obtain, the more they will be used, and the safer the practice can be.
In 2012, both New York and Tennessee required prescribers to check their state’s PDMP before prescribing painkillers.
The results one year later:
New York realized a 75% drop and Tennessee a 36% drop in patients who were seeing multiple prescribers to obtain the same drugs.
Although relieving pain and reducing suffering are primary emergency physician responsibilities, there is a concurrent duty to limit the personal and societal harm that can result from prescription drug misuse and abuse.
A study was conducted to estimate the societal costs of prescription opioid abuse, dependence, and misuse in the United States. Costs were grouped into three categories: health care, workplace, and criminal justice.
The results: Total US societal costs of prescription opioid abuse were estimated at $55.7 billion in 2007 (USD in 2009). Workplace costs accounted for $25.6 billion, health care costs accounted for $25.0 billion, and criminal justice costs accounted for $5.1 billion. Workplace costs were driven by lost earnings from premature death ($11.2 billion) and reduced compensation/lost employment ($7.9 billion).
Conclusions: The costs of prescription opioid abuse represent a substantial and growing economic burden for the society. The increasing prevalence of abuse suggests an even greater societal burden in the future.
PDMPs have many limitations in their current format, including complex access issues, timeliness, and whether the data are presented to the physician automatically or require physician effort to retrieve.
Attention to patterns of prescription requests and the prescribing of opioids as part of an ongoing relationship between a patient and a healthcare provider can decrease the risk of diversion. Periodic review of state PDMP, where available, is also a useful tool to monitor compliance. Evaluation should initially include…a drug history… Documentation is essential.
Use of a state PDMP may help identify patients who are at high risk for diversion or doctor shopping… To quantify the effects of PDMPs, studies were conducted of ED providers who cared for adult patients with pain. Of the patients with complete data in one study, information from the state’s PDMP System altered prescribing practice in 41%.
The CDC advises providers to use PDMPs… States should consider ways to increase their use … available real-time, and alerts to prescribers.
An improved PDMP … with accurate and timely data analysis should be regarded as the cornerstone of our collective efforts to address prescription drug abuse.
The abuse of opioid pain medication has a devastating impact on public health and safety in this country, killing 46 people every day… Prescription Drug poisoning deaths – now over 30,000/yr – outnumber deaths from motor vehicle crashes.
David is Prescription Advisory’s Chief Marketing Officer. Software startups are his passion.
He also serves as the Director of Startup Grind Princeton and a mentor for the Princeton University eLab.