Prescription Drug Monitoring Programs - PDMP Center of Excellence

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Prescription Drug Monitoring Programs: An Assessment of the Evidence for Best Practices 34Assistance Center and the PDMP COE. A survey of PDMP practices in this area would help identifyeffective approaches to public education and the sorts of reports and analyses that are appropriate forrelease and most influential in increasing PDMP awareness.Current adoption status: States vary to the extent to which they proactively disseminate findings andoutcomes related to PDMP data and activities to the wider public. A majority of PDMPs have websites(list available at www.pmpalliance.org/content/state-‐pmp-‐websites) that give an overview of programobjectives and operations but are largely configured to accommodate authorized PDMP users. However,a few programs also make data analyses available. For example, Maine offers recent PDMP news and anepidemiological evaluation of PDMP data from 2005 to 2008(www.maine.gov/dhhs/samhs/osa/data/pmp/index.htm), and Virginia posts reports showing increasedPDMP utilization and concomitant declines in doctor shopping rates(www.dhp.virginia.gov/dhp_programs/pmp/docs/ProgramStats/2010PMPStatsDec2010.pdf). Others,such as Kentucky, link to satisfaction surveys that document the valuable role PDMPs play in clinicalpractice, and to regular (e.g., quarterly) reports that show prescribing patterns by geographic area, forinstance the mostly widely prescribed drugs in each county.Barriers to adoption: Barriers to publicizing PDMP data and activities include resource limitations ingenerating data analyses, disseminating reports, and in expanding, updating, and maintaining websites.SummaryRationale: Raising awareness of PDMPs via websites, presentations, and reports may help build supportand help ensure funding.Evidence of effectiveness: Accumulated experience, key stakeholder perceptions.Current adoption status: Some PDMPs publicize findings via data summaries and reports via publicwebsites and other outlets.Barriers to adoption: Lack of staff resources to produce and disseminate reports, maintain websites.PDMP recruitment, utilization, and educationBest practices in recruitment, utilization, and education will maximize participation in a PDMP by allappropriate users. They will also promote understanding the value and application of PDMP data inprescribing and dispensing, drug diversion investigations, drug abuse prevention programs, planning andsiting drug treatment programs and office-‐based opioid treatment; and other activities that addressprescription drug abuse. Candidate practices include actions to:A. Enable access to PDMP data by all appropriate users; encourage innovative applicationsB. Outreach and recruitment strategies1. Proactively identify and conduct outreach to potential high-‐impact users2. Conduct recruitment campaigns3. Streamline certification and enrollment processing
Prescription Drug Monitoring Programs: An Assessment of the Evidence for Best Practices 354. Mandate enrollmentC. Approaches to increasing utilization1. Conduct promotional campaigns2. Improve data timeliness and access3. Conduct user education4. Mandate utilization5. Institute financial incentives6. Delegate accessA. Enable access to PDMP data by all appropriate users; encourage innovative applicationsRationale and evidence of effectiveness: PDMPs differ in their data access policies, sometimes making itdifficult for potential users to access PDMP data, such as health professional licensing boards and lawenforcement investigators. Some PDMPs selectively bar access to their data altogether by not expresslyauthorizing access for substance abuse treatment programs and professionals, medical examiners,Medicaid and Medicare agencies, workers’ compensation programs, and other third-‐party payers. Suchrestrictions can limit the effectiveness of PDMPs in helping to improve prescribing and in curtailingprescription drug abuse. PDMPs can therefore increase their effectiveness by seeking to widen access totheir data by all legitimate users, making sure sufficient safeguards and training are in place to maintainconfidentiality of prescription records, and prevent misuse of patient and prescriber information.BJA gives priority consideration for funding under its Harold Rogers Grant Program to PDMPs proposingto widen data utilization. In particular, local, state, and federal law enforcement agencies andinvestigators should be given case-‐appropriate access to PDMP reports (PDMP COE, NFF 2.3). Californiaand Texas, which have long provided both unsolicited and solicited reports to law enforcement agencies,and New York, which has provided such reports to narcotic enforcement investigators within theDepartment of Health, have lower than average death rates from unintentional opioid overdoses (Eadie,2011b; Paulozzi, 2010). To help curb prescription forgeries and theft, prescribers could be encouraged toconsult PDMP databases periodically to ensure that their DEA controlled substance number is not beingused surreptitiously (self-‐lookup).To maximize end-‐user participation, PDMPs first need to identify which types of potential users areoverly limited or barred from using PDMP data and those who are simply unaware of the PDMP. Theycan then undertake initiatives to enable such use, such as legislative and/or regulatory reform oroutreach to agencies or professional organizations.In addition, PDMP stakeholders should be encouraged to promote innovative applications of PDMPdata, along with evaluations of their effectiveness. New applications, perhaps involving new categoriesof users, may eventually become best practices that states can adopt in realizing the full potential ofPDMPs.
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Prescription Drug Monitoring Programs - PDMP Center of Excellence

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