Prescription Drug Monitoring Programs: What to Do When There is a Red Flag

Incorporating prescription drug monitoring programs (PDMPs) into daily practice is an integral step in assisting physicians who prescribe controlled substances, according to Matthew Foster, PharmD, who spoke on this subject during a session this week.

PDMPs are important, Dr. Foster noted, because patients have been shown to misuse these medications. A senior clinical pharmacy manager with Helios, Dr. Foster cited Centers for Disease Control and Prevention data that state:  “Nearly 15,000 people die every year of overdoses involving prescription painkillers,” and “In 2010, 1 in 20 people in the U.S. (age 12 or older) reported using prescription painkillers for nonmedical reasons in the past year.”¹

PDMPs give clinicians “access to legitimate medical use of controlled substances,” Dr. Foster noted, adding that they can help clinicians “identify, deter, or prevent drug abuse and diversion.”

The challenge with PDMPs, Dr. Foster said, is that not every state collects the same data.

“Additionally, some states restrict the prescriber’s ability to delegate accessing PDMP data to other staff members; this can lead to lower rates of accessing this important information,” he explained. “In states where accessing the PDMP is mandatory, it is still important that the appropriate follow-up actions occur based on the information.”

Only a “handful” of states include schedule V data, and even fewer collect data on nonscheduled medications, Dr. Foster noted.

There is also substantial variability between states regarding who can actually access PDMP data, Dr. Foster explained. Many states require that people requesting access to the state PMP database first register as an authorized user.

There is also variation among who is required to check the PDMP. For instance, Dr Foster explained, clinicians in Georgia must regularly check the PDMP on all new and existing patients, whereas in New York, Tennessee, and Kentucky, provisions state that health officials check the PDMP prior to prescribing.