Pew: Mandate PDMPs to avert overdose deaths

Prescription drug monitoring programs can help prevent opioid misuse and deaths.

Mandating that prescribers check prescription drug monitoring programs (PDMPs), such as before writing a patient’s initial prescription for a controlled substance, is the single most effective way to increase their use, according to a new report.

A study released earlier this year found that PDMPs nationwide prevent about one opioid death every two hours. But 22 of the states with PDMPs don’t require that prescribers use them, according to a report by the Pew Charitable Trusts and Brandeis University researchers.

States can reduce prescription opioid misuse and overdose deaths by using PDMPs, state-based electronic databases that track the prescribing and distribution of controlled substances, the report said. While PDMPs monitor patients' use of prescription opioids and can help doctors make decisions about whether to prescribe painkillers to patients, the number of prescribers actually using the databases remains low.

The latest report found that when states adopt one or more of eight strategies, they can increase clinician use of PDMPs. Along with state laws and regulations to require prescribers to check a patient’s data, other ways to increase the use of PDMPs are:

Delegation, which allows prescribers to designate someone on their staff, such as a nurse, to access the PDMP.

Communications from PDMP staff to prescribers, dispensers, law enforcement and regulators to flag potentially harmful drug use or prescribing activity.

Data timeliness, such as having pharmacies and prescribers upload information into the database at set intervals, whether in real time, daily, weekly or monthly.

Streamlined enrollment to simplify processes, such as instituting automatic PDMP registration triggered by state controlled substance registration, to more easily enable prescribers to enroll in a PDMP.

Educational and promotional initiatives, including prescriber training on how to access and use the data.

Health information technology (IT) integration to allow combining of PDMP data with other clinical data through technologies such as electronic health records. Such action would make it easier for doctors to check the databases for opioid misuse by patients, a pair of Yale doctors said.

Enhanced user interfaces that implement user-friendly technologies, such as dashboards and mobile applications that provide PDMP data in easily understandable formats.