While studies confirm that prescription drug monitoring programs (PDMPs) do help states reduce misuse and diversion of opioid drug products, many professionals and research data still report variable benefits, inconsistent usage, and an overall need for improvements to the system.
A recent Healthcare IT News article on “Opioid epidemic: Why aren't prescription drug monitoring programs more effective?” discussed the issue with various experts, including David Kilgo, director of systems implementation at Wolters Kluwer Clinical Effectiveness.
Every state except Missouri now has its own PDMP for reporting prescription drug data, and 46 of those are part of a collaborative data network. Nonetheless, the Healthcare IT News article hones in on several factors that interfere with PDMP effectiveness at reducing opioid abuse, misuse, and diversion:
- Regulations and requirements vary by state
- PDMPs are not easily integrated into prescriber workflow
- Lack of data standardization often limits information sharing between states
Kilgo shared insight on the second point: “In many instances, the prescriber must leave the screens in an EHR, log into the state website, search for the patient name, possibly making several selections due to the variation of names, and then return to the EHR to complete the work,” he explained. This frustrating process can affect professionals’ consistency in using the PDMP appropriately, thus impacting the quality of the data entered.
Kilgo also discussed the need for a unique patient identifier that would transcend state borders. He explained that regulations may differ depending upon in which state the clinician is based, as opposed to the state in which the patient resides or visits. With PDMPs only receiving “in-state” information, they are only recording a partial picture of the relevant patient activity, he said. “The very nature of a retrospective submission versus a real-time submission can cause a delay that reduces the effectiveness of the process.”
The experts agree, however, that PDMPs are constantly evolving and improving through technology advancements, workflow enhancements, and increased usage and understanding of the data they provide.
A helpful partner for PDMPs, Kilgo noted, is the e-prescribing of controlled substances. When states mandate e-prescribing, it creates “a gate for opportunistic prescribers” and assists in fraud prevention. It also helps create a workflow into which the PDMP can more smoothly integrate.