Prescription drug monitoring programs on rise, but physician usage remains low, study says

According to a new study from Johns Hopkins Bloomberg School of Health, only 53% of surveyed physicians use prescription drug monitoring programs (PMPs). Fewer than three-fourths of physicians knew about their state’s PMP.

The study, which appears in the March 2015 issue of Health Affairs, shows that while physician adoption of prescription drug monitoring plans has increased rapidly in the last few years, there is still a lot of work to be done to make them more effective.

PMPs are used in 49 states and the District of Columbia to give primary care physicians (PCPs) information to combat prescription drug abuse. Prescription drug monitoring plans are state-specific databases that allow PCPs to check for patient opioid abuse by collecting and monitoring the prescriptions of controlled substances. PCPs can see if patients are “doctor shopping” for opioid prescriptions and watchdogs can see if some PCPs are over-prescribing opioids. PMPs are an important tool in fighting prescription drug abuse and the study offers a range of solutions to help raise the rate of PMP usage among physicians. Raising these numbers can be an important step toward stopping drug abuse, concludes the study.

Prescription drug monitoring programs are becoming one of the “principal interventions” that states use to combat drug abuse. PMPs have been created by states in order to “collect, analyze, and report information on the prescribing and use of controlled substances” through state-specific electronic resources. In the last three years, 12 states have operationalized their programs.

Related:Primary care physicians scale back opioid prescribing in light of increased abuse

Most of the physicians surveyed felt PMP information had “at least some usefulness,” and three-fourths of those surveyed believed their prescribing of opioids had decreased since using the PMPs.

There are some barriers to PMP adoption. 28% of respondents thought program information was difficult to use. When the usage of PMPs is voluntary, they become less effective. Some physicians feel they can judge whether a patient is likely to have a drug problem or not through experience, according to the survey results.

In related numbers, 57% of those surveyed felt that their state’s program had greatly reduced or somewhat reduced prescription drug abuse. Twenty-eight percent thought PMPs had only reduced abuse by “a little,” while 8% felt PMPs had no effect. The remaining 7% felt the PMP were not in place long enough to properly assess the impact.

While physicians saw opioid abuse as a problem, there is the belief that the problem is occurring somewhere else. Sixty-two percent of the physicians surveyed felt their prescribing practices were under “little to no scrutiny” and prescription drug abuse was not occurring near them. The remaining 38% of physicians felt their prescribing practices were under “moderate or much scrutiny.”

Related:Are Medicare's patient satisfaction surveys contributing to opioid abuse?

The study suggests the best way to improve PMP usage is to require physicians to use them. New York, for instance, requires most prescribers to use the PMP before giving prescriptions for Schedule II, III and IV controlled substances. If physicians are not aware of PMPs, or are not legally required to use them, the fear is that they will not.

“Precription drug monitoring programs are promising state-level policy solutions to address prescription drug abuse and diversion,” concludes the study. “However, their long term success ultimately depends upon the degree to which physicians use them in routine clinical encounters.”