PDMP & Opioid Abuse News

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 information provided had an important impact.

Recommendations for full use of PDMP include:

• PDMPs can be effective clinical tools in medication management involving controlled substances.
• PDMPs should be available for clinicians across state boundaries.
• Every prescribing clinician should be familiar with the process of accessing and utilizing information from PDMP’s so that they can incorporate this information in their practices.

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 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.

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.

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.

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.

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 information provided had an important impact.

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.

Doctors (and other clinicians) need to know what prescriptions have been given to their patients by other practitioners. This information should be included in the patients’ electronic health care records accessible through a Prescription Drug Monitoring Program (PDMP) that provides immediate information.

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

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%.

Effective monitoring systems [PDMPs] will augment clinical judgment, provide evidence of misuse, and facilitate prescription of the most appropriate analgesic for the situation…The Emergency Department is regarded as the nation’s safety net…the last bastion of around-the-clock access to care … Unfortunately, some of the solutions to opioid misuse [limiting ED physicians to 3-day opioid prescriptions] preempts judgments from trained emergency medical providers.

The CDC advises providers to use PDMPs… States should consider ways to increase their use … available real-time, and alerts to prescribers.

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.

 

The use of PDMPs…is helping to reduce misuse of prescription drugs.