Improving PDMPs: Strengthening state tools to prevent prescription drug abuse

The problem of prescription drug abuse is complex and multi-faceted, and addressing the issue requires a multi-pronged, sustained approach involving a broad range of stakeholders. PhRMA and its members are committed to the appropriate use of prescription medicines and working with others to address the diversion, misuse and abuse of prescription medicine. Today, the Network for Excellence in Health Innovation (NEHI) released a report, with support from PhRMA, which reinforces the critical role that prescription drug monitoring programs (PDMPs) can play in preventing prescription drug abuse and provides recommendations on how to further strengthen PDMPs. The report includes the recommendations set forth by a NEHI expert panel on June 2, 2015 with physician leaders and pharmacy experts from across the U.S. Read below for more information about the report from NEHI’s own Tom Hubbard.

By Thomas Hubbard, Vice President of Policy Research, Network for Excellence in Health Innovation (NEHI) 

Families and communities across the country have been impacted by the critical public health and safety issue of prescription drug abuse. This issue continues to impact Americans’ lives and physicians are increasingly on the front lines helping to combat the problem.

Prescription drug monitoring programs, or PDMPs, have been identified as one tool to help prevent prescription drug abuse. PDMPs are state-run electronic databases that provide data on controlled substance prescriptions, which can be used to identify drug-seeking behaviors (e.g. “doctor shopping”) and avoid inappropriate prescribing.  

Unfortunately, these tools are being underutilized by prescribers because there are significant barriers and challenges to their use. A survey of primary care physicians from Johns Hopkins University found that one in four primary care physicians in states with a PDMP were not even aware they had one.

A number of measures are being considered to address these barriers and enhance the use and effectiveness of PDMPs, but it is key to engage physicians and the prescriber community to ensure PDMPs are meeting their needs. NEHI, with support from PhRMA, undertook a project to better understand the perspective of physicians and other prescribers in using PDMP systems.

NEHI found that, though prescribers recognized that PDMPs can be an invaluable tool for clinical practice, there are many ways that state systems can be strengthened:

• Improve Access and Usability of the PDMP: Pragmatic approaches should be considered, like making the registration processes less burdensome, reducing the high number of “click-throughs” required to access needed information and lessening the time burden associated in consulting the PDMP.
• Enhance Integrity of PDMP Data: In addition to improving the accessibility and usability of PDMP systems, NEHI found that PDMP data needs to be enhanced. The data should be as timely, accurate and inclusive as possible, including PDMP data from bordering states.
• Provide Proactive Alerts and Dashboards: PDMPs should proactively send alerts and data should be packaged for physicians in easy-to-read reports based on thoughtful, evidence-based criteria and triggers.
• Complement PDMP Systems with Other Clinical Data: Present PDMP data in a concise, “actionable” way with other relevant clinical data to help enhance physicians understanding of a patient’s risks.

Ultimately, strengthening PDMP programs is critically important to prevent abuse and diversion and ensure appropriate prescribing, and NEHI will continue to work with all impacted stakeholders to achieve better use of medicine in health care and address this growing public health problem.

A full version of recommendations and explanation can be found in NEHI’s issue brief.