Update on prescription monitoring in clinical practice: a survey study of prescription monitoring program administrators.

OBJECTIVE Prescription drug abuse and undertreatment of pain are public health priorities in the United States. Few options to manage these problems are balanced, in simultaneously supporting pain relief and deterring prescription drug abuse. Prescription monitoring programs (PMPs) potentially offer a balanced approach; however, the medical/scientific communities are not well informed about their current status and potential risks/benefits. The purpose of this study was to provide a benchmark of the current status of PMPs for healthcare providers upon which to engage PMP administrators. DESIGN A Web survey of current PMP directors with a telephone follow-up conducted in June-July 2006 regarding goals, data captured, data sharing procedures, healthcare provider training, and evaluation efforts. RESULTS Eighteen of 23 states with operating PMPs at that time participated. Eleven programs allowed physician access to PMP data. Data were delivered by mail (N = 6), fax (N = 8), e-mail (N = 1), and Websites (N = 8). Eight programs provided data to providers within 1 hour. Three states have developed provider PMP usage guidelines. Eight states developed or are developing educational programs. Two states completed or are conducting evaluations of the public health impact of PMP implementation. Five states have begun utilizing PMP data as an epidemiological tool. CONCLUSIONS Initial public safety orientation of PMPs is evolving to include improving public health and patient care. Beginning with efforts to engage healthcare providers through data sharing and education, and progressively including program evaluation on public health and patient care, our results suggest a rapid movement in the direction of utilization of PMPs to improve health care.

[1]  S. Butler,et al.  Development and validation of the Current Opioid Misuse Measure , 2007, PAIN.

[2]  R. Jamison,et al.  Urine Toxicology Screening Among Chronic Pain Patients on Opioid Therapy: Frequency and Predictability of Abnormal Findings , 2007, The Clinical journal of pain.

[3]  S. Butler,et al.  Validation and clinical application of the Screener and Opioid Assessment for Patients with Pain (SOAPP). , 2006, Journal of pain and symptom management.

[4]  G. Woody,et al.  A comparison of the abuse liability of tramadol, NSAIDs, and hydrocodone in patients with chronic pain. , 2006, Journal of pain and symptom management.

[5]  D. DeWalt,et al.  Predictors of opioid misuse in patients with chronic pain: a prospective cohort study , 2006, BMC Health Services Research.

[6]  Nora D Volkow,et al.  Major increases in opioid analgesic abuse in the United States: concerns and strategies. , 2006, Drug and alcohol dependence.

[7]  S. Fishman The DEA and Pain Medicine , 2006 .

[8]  M. Stitzer,et al.  The treatment of opioid dependence. , 2006 .

[9]  S. Butler,et al.  Validation of a screener and opioid assessment measure for patients with chronic pain , 2004, Pain.

[10]  S. Fishman,et al.  Regulating opioid prescribing through prescription monitoring programs: balancing drug diversion and treatment of pain. , 2004, Pain medicine.

[11]  R. J. Rose,et al.  Behavioral Monitoring and Urine Toxicology Testing in Patients Receiving Long-Term Opioid Therapy , 2003, Anesthesia and analgesia.

[12]  D. Brushwood Maximizing the Value of Electronic Prescription Monitoring Programs , 2003, Journal of Law, Medicine & Ethics.

[13]  L. Noah Challenges in the Federal Regulation of Pain Management Technologies , 2003, Journal of Law, Medicine & Ethics.

[14]  Gilbert J Fanciullo,et al.  Role of Urine Toxicology Testing in the Management of Chronic Opioid Therapy , 2002, The Clinical journal of pain.

[15]  Grant M. Carrow,et al.  Pain management and prescription monitoring. , 2002, Journal of pain and symptom management.

[16]  A. Gilson,et al.  Controlled substances and pain management: changes in knowledge and attitudes of state medical regulators. , 2001, Journal of pain and symptom management.

[17]  L. Simoni-Wastila,et al.  BALANCING DIVERSION CONTROL AND MEDICAL NECESSITY: THE CASE OF PRESCRIPTION DRUGS WITH ABUSE POTENTIAL , 2001, Substance use & misuse.

[18]  A. Gray,et al.  The economic burden of back pain in the UK , 1999, Pain.

[19]  R. Portenoy,et al.  Opioid therapy for chronic nonmalignant pain: a review of the critical issues. , 1996, Journal of pain and symptom management.

[20]  W. Cats-Baril,et al.  An overview of the incidences and costs of low back pain. , 1991, The Orthopedic clinics of North America.