Real-time prescription database curbs 'doctor shopping'

A central, real-time database helped reduce the number of inappropriate prescriptions filled in British Columbia, according to an article published this week in the Canadian Medical Association Journal.

A real-time processing system called PharmaNet was installed in 1995, linking all pharmacies and hospitals in the province to a central database. To determine its effect on "doctor shopping" for inappropriate prescriptions, the researchers compared records before and after. They looked at prescription records between Jan. 1, 1993, and Dec. 31, 1997,  for residents who either were on social assistance or were ages 65 and older. They labeled prescriptions for opioids or benzodiazepines inappropriate if they were written for at least 30 tablets of the same drug by a different doctor and taken to a different pharmacy within seven days, according to MedPage Today.

The researchers reported that in the six months after the system was installed, inappropriate prescriptions for opioids fell by 32.8 percent, and benzodiazepines decreased by 48.6 percent for those on social assistance. The levels already were low among seniors.

Colin Dormuth, an epidemiologist at the University of British Columbia in Vancouver, told Reuters that the number of inappropriate prescriptions flagged probably is higher now because his research team's definition was narrow.

"The cost of implementing these networks in terms of the hardware and resources to build them is probably trivial compared to the millions of inappropriate prescriptions that can be prevented," Dormuth said.

Earlier this summer, New York Gov. Andrew Cuomo signed a bill creating a real-time prescription database called I-STOP. The bill requires doctors in the state to issue electronic prescriptions for painkillers within three years and to check patient records online before doing so.

Though 49 states have prescription drug monitoring programs or have passed legislation authorizing them,  they aren't used enough, according to the U.S. Department of Health & Human Services. The Office of the National Coordinator for Health IT recently launched pilots in Indiana and Ohio to determine how to boost providers' access to data.

Efforts to thwart doctor shopping in New York recently resulted in 98 arrests in one instance; in another instance, a Long Island doctor was charged with prescribing 782,032 oxycodone pills within three years to people he knew were addicted to the drugs.

To learn more:
- read the journal article's abstract
- here's the MedPage today piece
- check out the Reuters story

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