Prescription drug monitoring systems alert abuse

By Piriya Mahendra, medwireNews Reporter

Electronic prescription monitoring programs (PMPs) may significantly improve drug-abuse detection and could alert clinicians to "doctor shopping," say researchers.

An electronic PMP allows pharmacists and practitioners to gather drug information about the patients they serve, including the date a prescription was first issued, how many drug providers prescribed, how often, and from which pharmacies a patient has received a drug.

This enables clinicians to determine questionable medication behavior or doctor shopping, a practice whereby patients seek to obtain multiple prescriptions for abusable medications from different doctors. It also enables medications to be cataloged so that contraindications or increased risk for adverse events can be flagged, as reported in Pain Medicine.

"PMPs have historically been oriented to criminal and judicial end users," commented lead author Traci Green (The Miriam Hospital, Providence, Rhode Island, USA) in a press statement. "Use of PMPs by prescribers is growing, but how clinicians in actual practice use the data that these systems contain is not well understood."

Green and team surveyed the states of Connecticut and Rhode Island and found that PMP use was significantly greater in Connecticut, at 43.9% versus 16.3%.

Overall, 36.2% of PMP users in Connecticut used PMP patient reports to screen for drug abuse in patients compared with 10.0% of PMP users in Rhode Island. Moreover, 43.9% of Connecticut PMP users used PMP reports to detect doctor shopping versus 18.5% in Rhode Island.

Regression analysis indicated that PMP users were a significant 75% more likely than nonusers to respond to suspected drug abuse or doctor shopping by referring the patient to another provider, 93% more likely to screen the patient for drug abuse, and 97% more likely to revisit but not initiate a treatment agreement/pain contract with the patient.

PMP users were also 82% more likely than nonusers to conduct a urine drug screen of the patient and 30% more likely to refer patients for substance abuse treatment.

In addition, PMP users were 55% less likely than nonusers to notify law enforcement and 91% less likely to do nothing about the patient or ignore their suspicions.

"One thing is clear," remarked Green, "Clinicians, not law enforcement, have the medical and behavioral health care expertise to guide patients struggling with addiction to get the help they need, when they are ready for it."

"PMPs can be an important clinical tool to address possible addiction issues and start that conversation."

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