State prescription drug-monitoring programs (PDMPs) could be improved by integrating their information into electronic health records, allowing their data entry to be delegated, and including unsolicited reports of potential abusers, according to a new analysis from the Pew Charitable Trusts.
Cynthia Reilly, director of Pew's Prescription Drug Abuse Project, wrote in the report that current monitoring programs in nearly every state are not as effective as they could be because they are too time-consuming for doctors.
“PDMPs are a great information source, but now we need to get that information into the hands of the people who need it,” Reilly said.
The nationwide opioid addiction epidemic has sparked many policy and political discussions about how to stop it. The White House asked for $1.1 billion to fight opioid overuse in its fiscal 2017 budget request, and much of that money would be directed to state programs.
Reilly said that state adoption of monitoring programs has increased significantly in the past five years, as mounting evidence has proven their effectiveness. Now states need to focus on improving their programs.
“We're definitely seeing a lot of change in this space right now,” she said.
Allowing nurses or office staff to work with the PDMP report could allow doctors to spend more time with the patient, while still providing access the information. Integrating the programs with EHRs would allow prescribers to see the patient's prescription history at the point of care, which is “an ideal scenario,” Reilly said.
The Office of the National Coordinator for Health Information Technology established pilot programs to integrate the systems into several healthcare settings in 2011. An analysis of the pilots showed that the integration improved real-time data reporting and increased the number of doctors using PDMP information.
Reilly acknowledged that EHR implementation has been difficult for some providers, but that wider and better use of the technology would make the programs more comprehensive.
She also suggested that unsolicited drug-abuse reports be sent to prescribers and pharmacies to alert them of patients with potentially dangerous behavior.
The Centers for Disease Control and Prevention has been developing voluntary guidelines for primary-care providers who prescribe opioid pain medications. It has received some negative feedback for not including enough input from doctors, and advocates have said they are concerned the CDC guidelines could limit access to medications for chronic-pain sufferers who need them.
The guidelines recommend that providers check the PDMPs when first prescribing opioids, and then again periodically if continuing that treatment. The documentation noted that there is limited evidence on the effectiveness of prescription drug-monitoring programs in reducing the number of fatal overdoses, but the data they collect link to such deaths.