Prescription drug monitoring program use continues to rise

Clinicians queried PDMPs more than 300 million times in 2017, but it has led to unintended harms, says Leo Beletsky.


Physician use of state-run prescription drug monitoring programs is dramatically increasing while doctors have decreased opioid prescribing nationwide for the fifth consecutive year.

That’s among the findings of a new report released on Thursday by the American Medical Association, which the organization says shows progress toward reversing the U.S. opioid epidemic.

According to the AMA, the number of opioid prescriptions decreased by more than 55 million—a 22.2 percent decrease nationally—between 2013 and 2017, with a 9 percent decrease—more than 19 million fewer prescriptions—between 2016 and 2017. In fact, all 50 states have seen a decrease in opioid prescriptions over the last five years, notes the report.

In addition, last year, clinicians across the country queried PDMPs more than 300.4 million times—a 121 percent increase from 2016 and a 389 percent increase from 2014. Both states with and without mandates to use PDMPs—electronic databases that track controlled substance prescriptions by flagging suspicious patient prescribing activities—saw large increases, notes the AMA.

“Today, more than 1.5 million physicians and other healthcare professionals are registered in state-based PDMPS. Between 2016 and 2017, more than 241,000 individuals registered,” according to the AMA, which contends that these databases that help track controlled substance prescriptions need to be better integrated into clinical workflows to provide data at the point of care.

Also See: EHRs need better integration with prescription drug monitoring programs

“As PDMPs improve, America’s physicians and healthcare professionals are using state PDMPs more than ever,” states AMA’s Opioid Task Force 2018 Progress Report.

However, Leo Beletsky, associate professor of law and health sciences at Northeastern University, believes that the recent scale-up in the number, scope, funding, and legal mandates of these databases has led to unintended harms that have not received sufficient attention.

“By collecting information on who is prescribing, dispensing and receiving scheduled drugs, PDMPs are intended to detect—and deter—problem patients, rogue prescribers, and pharmacists who may be diverting potentially addictive and otherwise risky drugs,” writes Beletsky last month in the Indiana Health Law Review. “The success of PDMPs has been measured primarily by their impact on suppressing medication supply with little regard for truly meaningful metrics. But, when it comes to improving patient care and addressing drug-related harms, the evidence of PDMP benefit is far from clear.”

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