Leading a Horse to Water: Facilitating Registration and Use of a Prescription Drug Monitoring Program.
OBJECTIVE
Prescription Drug Monitoring Programs (PDMPs) can help inform patient management, coordinate care, and identify drug safety risks, abuse, or diversion. However, many clinicians are not registered to use these systems, and use may be suboptimal. We sought to describe outreach efforts in 1 state (Oregon); quantify uptake of system use; identify barriers; and identify potential system improvements.


METHODS
Program reports of outreach efforts and operational metrics provided rates of registration and use. A statewide survey identified perceived barriers and potential improvements from users and nonusers of the system.


RESULTS
Even with extensive registration efforts, <25% of clinicians and pharmacists acquired PDMP accounts over 2 years of operation. Rapid increases in registration and use in 2013 corresponded to new requirements among large pharmacy chains that pharmacists register for and use the PDMP. Among surveyed PDMP nonusers, nearly half were unaware that they could register. Among users and nonusers, over two thirds indicated that time constraints were a major barrier and over half thought that inability to delegate access was a major barrier. Desired improvements included linking state systems, faster entry of pharmacy data, and use of unique patient identifiers. Users also wanted better insurance coverage for mental health and addiction referrals.


CONCLUSIONS
Increasing registration and use of PDMPs remains important. Clinician feedback indicates that program enhancements and health care system changes would facilitate using and responding to PDMP information. It appears premature to judge the efficacy of PDMPs until best practices for their use are identified and impacts are assessed.
Departments of Family Medicine.|Internal Medicine.|Public Health and Preventive Medicine, Center for Research in Occupational and Environmental Toxicology, Oregon Health and Science University.|Acumentra Health.
Richard A
RA
Deyo
Acumentra Health.
Jessica M
JM
Irvine
Acumentra Health.
Sara E
SE
Hallvik
Acumentra Health.
Christi
C
Hildebran
Public Health Division of the Oregon Health Authority, Portland, OR.
Todd
T
Beran
Public Health Division of the Oregon Health Authority, Portland, OR.
Lisa M
LM
Millet
Departments of Family Medicine.|Public Health and Preventive Medicine, Center for Research in Occupational and Environmental Toxicology, Oregon Health and Science University.
Miguel
M
Marino