Barriers Prevent Widespread Use of Prescription Drug Monitoring Programs

While the majority of primary care physicians are aware of and use state prescription drug monitoring programs (PDMPs) to reduce drug abuse and diversion, many do not access these programs routinely, according to researchers from the Johns Hopkins Bloomberg School of Public Health.

The study, published in Health Affairs, found nearly one-fifth of physicians were not at all aware of their state’s PDMP. The authors surveyed 420 primary care physicians and found that while 72% were aware of the program, only 53% reported having used it.

“The success of these programs depends on physicians’ knowledge, impressions and use of them,” study leader Lainie Rutkow, JD, PhD, an associate professor in the department of health policy and management at the Bloomberg School, said in a statement. “While awareness of the programs is relatively high, barriers exist. The information in our report about the barriers physicians face will give states something to focus on.”

State drug monitoring programs include databases that allow physicians to identify people who obtain prescriptions from multiple physicians and other potentially illicit or abusive behaviors. Missouri is the only state without a PDMP in place. In the last 3 years, 12 states had introduced new programs.

Since state-run PDMPs are still fairly new—the earliest ones introduced in just the past decade—Dr Rutkow was not surprised that 22% of respondents were unaware of their state’s program. However, she views the lack of knowledge as an opportunity for states to make improvements.

“To increase the use of the programs in clinical practice, states should consider implementing legal mandates, investing in prescriber education and outreach, and taking measures to enhance ease of access to and use of the programs,” the authors suggested.

PDMPs are also highlighted in the newest issue of the New England Journal of Medicine, with a Viewpoint paper describing the benefits of, the evidence behind, and provider concerns with mandates.

While the evidence regarding association of state PDMPs with lower rates of prescription drug abuse is mixed, there are clear benefits from increased participation in these programs, according to authors Rebecca L. Haffajee, JD, MPH, from Harvard Medical School and Harvard Pilgrim Health Care Institute; Anupam B. Jena, MD, PhD, from Harvard Medical School, Massachusetts General Hospital, and the National Bureau of Economy Research; and Scott G. Weiner, MD, MPH, of Brigham and Women’s Hospital.

“When a critical mass of prescribers use PDMP information, the collective care each patient receives across providers theoretically can be improved and efficiencies are less likely to be compromised by any one uninformed practitioner,” the authors wrote.

However, mandating the use of these programs may not be the way to go as prescribers cite generic problems that may be exacerbated under a mandate, such as difficulty obtaining logins, information not integrated into clinical workflow, and incomplete data.

The Health Affairs study also cited that barriers such as the time-consuming nature of information retrieval and the lack of an intuitive format for data may prevent greater use of PDMPs.