If prescription drug monitoring programs were more efficient, providers would 'do the right thing'

Prescription drug monitoring programs have been proven effective, particularly in curbing the effects of the opioid epidemic, but mandates can be a hard sell to providers who are already strapped for time.

The key is to make PDMPs more efficient and to integrate their use into the existing workflow for clinicians, said Thomas R. Bizzaro, resident pharmacist and vice president for health policy and industry relations for First Databank, during a webinar hosted by the Pharmacy Quality Alliance.

This can be a challenge as there are few uniform standards for PDMPs and they often fail to provide data in a timely manner, at the point of care, he said.

Docs typically spend six to eight minutes reviewing reports for risk signs of opioid abuse, he said. It's untenable to spend that much time on every patient, so the process must be streamlined to encourage providers to use it.

One strategy is to use a “facilitator,” according to a model developed by the National Council for Prescription Drug Programs (NCPDP). A facilitator system would relay information to providers more quickly and encourage interoperability between clinicians, pharmacists and other stakeholders, Bizzaro said. The facilitator would process electronic prescriptions as they’re submitted to pharmacies and identify patients at risk for drug abuse before the prescriptions are dispensed.

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Incorporating a facilitator into existing PDMPs or other provider systems would not disrupt or hinder care delivery, he said. NCPDP’s model calls for a national facilitator that would work across state lines, Stephen C. Mullenix, resident pharmacist and NCPDP’s senior vice president for public policy and industry relations, said. A nationwide database would make data sharing easier, but would still allow states a level of autonomy in regulations.

Mullenix said implementing facilitators or other PDMP models is “not a silver bullet” to solving industry problems like inappropriate prescribing or opioid abuse, but efficient and effective PDMPs help providers make the right, safe choices for patients. It’s necessary for conversation about prescription monitoring to frame it as a clinical issue and include clinicians in the discussion, he said.

“We’re also sending a message to the industry, to the nation [that] we have confidence that if we give accurate, timely information to those healthcare professionals entrusted with the care of patients, and do that in an efficient manner, then they will overwhelmingly do the right thing,” Mullenix said.