prescription monitoring program (PDMP)
Jump to navigation
Jump to search
Indications
- created to diminish prescription drug abuse & diversion
- an alert physicians if patients are getting controlled substances from another provider
Notes
- state-run systems that gather information on controlled substance prescriptions from pharmacies & prescribers
- allows prescribers to view patient' controlled substance history & monitor controlled substance use
- information is useful for documenting adherence & for early detection of possible abuse*
- 30% overall decrease in prescribing rates for Schedule II opioids[3]
- uncertain value in preventing opioid overdose deaths[5]
- need to register online
- prescriptions that are filled but never picked up will show up in the system
- nearly 2/3 of patients with opioid dependence without opioid precriptions logged into the system in the prior 12 months[4]
- no demonstrated benefit for mandatory prescription drug monitoring with elective surgery[6]
- it does not document
- treatment with methadone at an opioid treatment program
- arrest for selling drugs
- a diagnosis of substance abuse
- reason(s) for seeking a new prescriber
- healthcare encounters for drug overdose(s)
* this is only true if system works as intended & patient obtains all opiates through a prescriber that commits to the prescription monitoring program
* it does not determine whether the patient is actually taking the medications or is transferring them to another individual
* as such, this a hugely short-sighted program, useful for what it does do, but far short of reasonable effort
* regular urine drug screens should be used to determine that the patient is actually taking an opiate, but this in itself is also inadequate
More general terms
References
- ↑ Prescriber's Letter 17(7): 2010 Prescription Drug Monitoring Programs Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260701&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 17, 18. American College of Physicians, Philadelphia 2015, 2018.
- ↑ 3.0 3.1 Bao Y, Pan Y, Taylor A et al. Prescription drug monitoring programs are associated with sustained reductions in opioid prescribing by physicians. Health Aff (Millwood) 2016 Jun 1; 35:1045 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27269021
- ↑ 4.0 4.1 Hawk K, D'Onofrio G, Fiellin DA et al. Past-year prescription drug monitoring program opioid prescriptions and self-reported opioid use in an emergency department population with opioid use disorder. Acad Emerg Med 2017 Nov 22 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29165853 <Internet> http://onlinelibrary.wiley.com/doi/10.1111/acem.13352/abstract
- ↑ 5.0 5.1 Fink DS, Schleimer JP, Sarvet A et al. Association between prescription drug monitoring programs and nonfatal and fatal drug overdoses: A systematic review. Ann Intern Med 2018 May 8; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29801093 <Internet> http://annals.org/aim/article-abstract/2680723/association-between-prescription-drug-monitoring-programs-nonfatal-fatal-drug-overdoses
Compton WM, Wargo EM. Prescription drug monitoring programs: Promising practices in need of refinement. Ann Intern Med 2018 May 8 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29801101 <Internet> http://annals.org/aim/article-abstract/2680724/prescription-drug-monitoring-programs-promising-practices-need-refinement - ↑ 6.0 6.1 Stucke RS, Kelly JL, Mathis KA et al Association of the Use of a Mandatory Prescription Drug Monitoring Program With Prescribing Practices for Patients Undergoing Elective Surgery JAMA Surg. Published online August 22, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30140927 https://jamanetwork.com/journals/jamasurgery/fullarticle/269662