title: How does use of a prescription monitoring program change pharmacy practice?
abstract: OBJECTIVE
  To assess differences in prescription monitoring program (PMP) use between two states with different PMP accessibility (Connecticut [CT] and Rhode Island [RI]), to explore use of PMPs in pharmacy practice, and to examine associations between PMP use and pharmacists' responses to suspected diversion or "doctor shopping."
  
  
  METHODS
  Descriptive nonexperimental study.
  
  
  METHODS
  CT and RI from March through August 2011.
  
  
  METHODS
  Licensed pharmacists in CT and RI.
  
  
  METHODS
  Anonymous surveys e-mailed to pharmacists
  
  
  METHODS
  PMP use, use of patient reports in pharmacy practice, and responses to suspected doctor shopping or diversion.
  
  
  RESULTS
  Responses from 294 pharmacists were received (CT: 198; RI: 96). PMP users were more likely to use the PMP to detect drug abuse (CT: 79%; RI: 21.9%; P < 0.01) and doctor shopping (67%; 7%; P < 0.01). When faced with suspicious medication use behavior, PMP users were less likely than nonusers to discuss their concerns with the patient (adjusted odds ratio 0.48 [95% CI 0.25-0.92]) but as likely to contact the provider (0.86 [0.21-3.47]), refer the patient back to the prescriber (1.50 [0.79-2.86]), and refuse to fill the prescription (0.63 [0.30-1.30]). PMP users were less likely to state they were out of stock of the drug (0.27 [0.12-0.60]) compared with nonusers. Pharmacists reported high interest in attending continuing education on safe dispensing (72.8%).
  
  
  CONCLUSIONS
  Pharmacists are important participants in the effort to address prescription drug misuse and abuse. Current PMP use with prevailing systems had limited influence on pharmacy practice. Findings point to future research and needed practice and education innovations to improve patient safety and safer opioid dispensing for pharmacists.
authors.affiliation: Rhode Island Hospital, 55 Claverick St., 2nd floor, Providence, RI 02903, USA. traci.c.green@gmail.com
authors.forename: Traci C
authors.initials: TC
authors.lastname: Green
authors.forename: Marita R
authors.initials: MR
authors.lastname: Mann
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Bowman
authors.forename: Nickolas
authors.initials: N
authors.lastname: Zaller
authors.forename: Xaviel
authors.initials: X
authors.lastname: Soto
authors.forename: John
authors.initials: J
authors.lastname: Gadea
authors.forename: Catherine
authors.initials: C
authors.lastname: Cordy
authors.forename: Patrick
authors.initials: P
authors.lastname: Kelly
authors.forename: Peter D
authors.initials: PD
authors.lastname: Friedmann
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D003237:Connecticut; D004513:Education, Pharmacy, Continuing / Q000379:methods; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000517:prevention & control; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010593:Pharmaceutical Services / Q000458:organization & administration*; D010595:Pharmacists / Q000458:organization & administration*; D010818:Practice Patterns, Physicians'; D063487:Prescription Drug Misuse; D012237:Rhode Island; D019966:Substance-Related Disorders / Q000517:prevention & control
chemical_list: D000701:Analgesics, Opioid