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Prescription medications can include controlled substances, such as opioids and benzodiazepines. The misuse of these medications can lead to severe consequences and has contributed to the opioid epidemic seen in the United States in recent years. The Prescription Drug Monitoring Program helps keep track of prescriptions and reduces some of these risks.
- The Prescription Drug Monitoring Program (PDMP) is a database of prescribed controlled substances used to monitor the use of medications.
- Clinicians can use the PDMP to inform clinical decisions and identify at-risk individuals.
- The PDMP is accessible by any approved clinicians across the US.
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What is the prescription drug monitoring program (PDMP)?
The prescription drug monitoring program (PDMP) is a database used to record controlled substance prescriptions across the United States. Clinicians can access the PDMP to help inform clinical decisions and prescriptions, guide individual and statewide interventions, and reduce risks of overdose and misuse. [1]
The PDMP was implemented in response to the opioid epidemic, in an attempt to help monitor the use of prescription opioids and other controlled substances. [2] The opioid epidemic refers to the rapid increase in misuse and overdose caused by illicit and prescribed opioids in recent years.
To help reduce these risks, the PDMP monitors and analyzes individual prescriptions. This helps prevent issues such as “doctor shopping”, which involves one person attending several clinicians to receive multiple prescriptions for their own use or to sell to others. [2]
How do PDMPs work?
Prescription Drug Monitoring Programs (PDMPs) function as statewide databases that track the prescribing and dispensing of controlled substances. By monitoring prescription patterns, PDMPs help identify potential risks and promote responsible medication use.
Related: The MATE Act and Where To Get Training
Data collection and integration
PDMPs require pharmacists to input data regarding any controlled substance they dispense, including the drug, dose, date of dispensing, prescriber, patient, and dispensing pharmacy. This data is reported at regular intervals, is accessible by clinicians, and is intended for regular monitoring. [1]
Prescribers and other dispensers can then check the PDMP to monitor for at-risk individuals, such as those who receive multiple prescriptions or unsafe doses.
Access and usage
PDMPs are integrated into electronic health record systems, which means that access to PDMP information can be permitted to professionals across the country to ensure necessary information is adequately shared. [1]
This includes prescription histories, allowing clinicians to view an individual’s past prescriptions to inform current and new prescriptions and clinical decisions. PDMP information helps clinicians easily identify individuals who may be at risk of misuse or overdose, regardless of the availability of their other health records or historical information. [3]
Differences in PDMPs by state
States enforce slightly different policies or laws relating to the use of PDMPs, such as: [2][4]
- Some states have policies that require clinicians to check PDMPs before prescribing a drug.
- States differ in terms of which agencies can access data, such as law enforcement, research organizations, and Medicaid programs.
- Data collection methods may differ between states due to a lack of standardization in data collection and reporting.
PDMP limitations
Some of the potential challenges and limitations of PDMPs include: [2][4][5]
- Healthcare providers may not always check the database before making treatment decisions.
- Pharmacies enter information about dispensed prescriptions into the PDMP which is submitted to the state at varying times; in some cases, this happens almost immediately, and in others, it occurs monthly, impacting the available information on the database.
- PDMPs give a risk score for each patient, which is created by software algorithms and can help inform clinical decisions but should not replace professional judgment.
- Clinician bias or assumptions can impact how effectively PDMPs are used.
- Comprehensive training is required to adequately use PDMPs.
How to use a PDMP as a healthcare provider
When using a PDMP, healthcare providers should ensure that they check the individual’s identity. Information on the PDMP can inform clinical decisions including the type and dosage of medications prescribed. Depending on the person’s risks, it can guide any information, advice, or interventions given. [3]
- Check the PDMP before prescribing a new medication and at regular intervals, such as every three months, when reviewing or continuing treatment.
- Coordinate with other professionals involved in the patient’s care to ensure that necessary PDMP information is adequately shared.
- Assess the patient’s risk using the scores calculated by the PDMPs algorithm and historical data on their file.
- Check PDMP records for current and historical prescriptions, which can help highlight and avoid any prescription medication risks such as combining dangerous doses of opioids and benzodiazepines.
Future of PDMPs
Currently, PDMP laws and data collection differ by state. However, to improve functionality, the structure and utilization of PDMPs may become uniform across the US. Issues relating to the implementation and development of PDMPs continue to be discussed and amended by those involved. [5]
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