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. 2014 Jul;15(7):747-55.
doi: 10.1016/j.jpain.2014.04.003. Epub 2014 Apr 29.

Who uses a prescription drug monitoring program and how? Insights from a statewide survey of Oregon clinicians

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Who uses a prescription drug monitoring program and how? Insights from a statewide survey of Oregon clinicians

Jessica M Irvine et al. J Pain. 2014 Jul.

Abstract

Prescription drug monitoring programs (PDMPs) are relatively new but potentially useful tools to enhance prudent prescribing of controlled substances. However, little is known about the types of clinicians who make the most use of PDMPs, how these programs are incorporated into clinicians' work flow, or how clinicians and patients respond to the information. We therefore surveyed a random sample of Oregon providers, with 1,065 respondents. Clinicians in emergency medicine, primary care, and pain and addiction specialties were the largest number of registrants, but many frequent prescribers of controlled substances were not registered to use the PDMP. Among users, 95% reported accessing the PDMP when they suspected a patient of abuse or diversion, but fewer than half would check it for every new patient or every time they prescribe a controlled drug. Nearly all PDMP users reported that they discuss worrisome PDMP data with patients; 54% reported making mental health or substance abuse referrals, and 36% reported sometimes discharging patients from the practice. Clinicians reported frequent patient denial or anger and only occasional requests for help with drug dependence. More research is needed to optimize how clinicians use PDMPs across settings and how clinicians and patients respond to the data.

Perspective: This study examined differences between PDMP users and nonusers and how clinicians in various specialties use PDMPs in practice. A better understanding of effective PDMP use will facilitate access to treatment for patients with pain while curbing the prescription drug epidemic and may ultimately reduce abuse, misuse, and overdose death.

Keywords: Prescription drug monitoring program; controlled substances; opioid prescribing; prescription drug abuse; survey.

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Figures

Figure 1
Figure 1
Percentage of registered users (high + low) who reported that training on various topics would make the PDMP somewhat or very useful in clinical practice.

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