Most U.S. states now have prescription drug monitoring programs (PDMPs) available to help physicians identify patients who may be abusing medications such as opioids or who are engaged in doctor shopping for diversion. However, little is known about the extent to which physicians use PDMP information or how they use it in their clinical practice. A team of Oregon researchers conducted online focus groups (and in some cases follow-up interviews) with 35 clinicians in 9 states, to gather preliminary evidence about these issues. Use of PDMPs was highly variable among the physicians, with some (especially those at pain clinics) checking the PDMP with each visit of every patient and others only checking it for new patients, for new opioid prescriptions, or for patients suspected of prescription drug abuse. The participants revealed a wide range of approaches to dealing with patients whose PDMP data raised red flags—from direct confrontation, to nonjudgmental discussion, to avoidance of the issue altogether. The participants reported several barriers to more consistent use of PDMP information to change prescribing practices, including the importance they place on positive patient satisfaction ratings, which may be negatively influenced by a confrontation with a patient over suspected abuse. Further research is needed to understand PDMP use (and non-use) among clinicians more widely, in order to remove obstacles to fuller integration of PDMP information into healthcare and to develop “best practices” guidelines.
For a copy of the abstract for this paper, please go to
http://onlinelibrary.wiley.com/doi/10.1111/pme.12469/abstract.