Prescription drug monitoring program design and function: A qualitative analysis

• Published in: Drug and alcohol dependence 2017-11, Vol.180, p.395-400
• Main Authors: Rutkow, Lainie, Smith, Katherine C., Lai, Alden Yuanhong, Vernick, Jon S., Davis, Corey S., Alexander, G. Caleb
• Format: Article
• Language: English
• Subjects: Analgesics, Opioid - therapeutic use; Computerized medical records; Data Accuracy; Data processing; Data quality; Data retrieval; Decision making; Drug development; Drug Overdose - drug therapy; Electronic Health Records; Electronic medical records; Enforcement; Humans; Law Enforcement; Medical education; Medical records; Morbidity; Mortality; Narcotics; Opioid; Opioid-Related Disorders - drug therapy; Opioids; Overdose; PDMP; Physicians; Prescribing; Prescription Drug Misuse - prevention & control; Prescription drug monitoring program; Prescription Drug Monitoring Programs; Prescription drugs; Prescription Drugs - therapeutic use; Public health; Public health practice; Qualitative analysis; Qualitative research; Snowball sampling; Therapeutic drug monitoring
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2017.08.040

•We conducted 37 interviews with state actors about Prescription Drug Monitoring Program (PDMP) goals and characteristics.•PDMP goals included improving prescribing practices and identifying doctor shoppers.•Future PDMP efforts included data sharing and analysis and training for PDMP users.•Findings highlight areas state governments may want to prioritize for their PDMP. Opioid-related overdose deaths are a major public health challenge. Forty-nine states have implemented Prescription Drug Monitoring Programs (PDMPs) that collect information about individuals’ prescription medications. Little is known about state governments’ implementation of PDMPs. We conducted semi-structured interviews with PDMP staff, law enforcement officials, and administrative agency employees to learn about their attitudes and experiences with PDMPs. From May 2015 to June 2016, we conducted 37 semi-structured interviews with state actors in four states. Questions focused on interviewees’ perceptions about PDMP goals, home agency characteristics, and future PDMP initiatives. States were selected purposively. Interviewees were identified through purposive and snowball sampling. Interviewees identified key PDMP goals as: improve patient treatment decisions; influence prescribing practices; assist in the identification of “doctor shoppers”; and serve as a tool for law enforcement. Interviewees identified the following characteristics as key for a PDMP’s home agency: regulatory and enforcement authority; intra- and inter-agency collaboration; and commitment to data quality and protection. Interviewees identified three promising areas for future PDMP efforts: data sharing and analysis; integration of PDMP data with electronic medical records; and training for current and potential PDMP users. Our findings reveal areas that states may want to prioritize, including improving prescribers’ knowledge and use of the PDMP as well as fostering inter-agency collaborations that include PDMP staff. By capitalizing on these opportunities, state governments may improve the effectiveness of their PDMPs, potentially making them more useful tools to curb the morbidity and mortality associated with opioid use disorders.