Dr. Murphy reported to the board that both clinic sites see roughly 100 to 120 patients per day and checks the Prescription Drug Monitoring Program database (PDMP) 20-30 times each day.

However, the board points to information from the database, which is starkly different. During the period between January and April 15, 2015, “PDMP records reflect that Dr. Murphy or his office accessed the PDMP site 190 times on 7,000 patients visits. Thus, with an average of 91 patients per day, the PDMP was checked less than five times per day.”

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You’re not only reducing the supply [of pain medications] for those who use them inappropriately, but also for those in need.

Bob Tillman – Director of Policy and AdvocacyAmerican Academy of Pain Management

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.

Setting
Clinicians from pain management, emergency and family medicine, psychiatry/behavioral health, rehabilitation medicine, internal medicine and dentistry participated.

Patients
Thirty-five clinicians from nine states participated.

Methods
We conducted two online focus groups and seven telephone interviews. A multidisciplinary team then used a grounded theory approach coupled with an immersion–crystallization strategy for identifying key themes in the resulting transcripts.

Results
Some participants, mainly from pain clinics, reported checking the PDMP with every patient, every time. Others checked only for new patients, for new opioid prescriptions, or for patients for whom they suspected abuse. Participants described varied approaches to sharing PDMP information with patients, including openly discussing potential addiction or safety concerns, avoiding discussion altogether, and approaching discussion confrontationally. Participants described patient anger or denial as a common response and noted the role of patient satisfaction surveys as an influence on prescribing.

Conclusion
Routines for accessing PDMP data and how clinicians respond to it vary widely. As PDMP use becomes more widespread, it will be important to understand what approaches are most effective for identifying and addressing unsafe medication use.

Pain Medicine, Volume 15, Issue 7, July 2014 
David Stengle

David Stengle

Chief Marketing Officer at Prescription Advisory
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.
David Stengle
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