title: Integration of prescription drug monitoring programs (PDMP) in pharmacy practice: Improving clinical decision-making and supporting a pharmacist's professional judgment.
abstract: BACKGROUND
  Pharmacists have shared responsibility to investigate the validity of controlled substance prescriptions (CSPs) that raise concerns, or red flags, and subsequently exercise their right to refuse to dispense a CSP if its validity cannot be verified. Improving access to clinical practice tools, such as prescription drug monitoring programs (PDMPs), may increase availability of a patient's drug history, which is critical to making informed clinical decisions about dispensing CSPs.
  
  
  OBJECTIVE
  The purpose of this study was to examine how integration and consistent use of a PDMP in pharmacy practice impacts pharmacists' dispensing practices related to CSPs.
  
  
  METHODS
  A cross-sectional study examined pharmacists' knowledge and use of Indiana's (US State) PDMP (INSPECT) and dispensing practices of CSPs. Three outcome measures were analyzed using multiple logistic regression so as to examine the relationship between PDMP use and pharmacists' controlled substance dispensing behaviors.
  
  
  RESULTS
  Pharmacists were 6.4 times more likely to change their dispensing practice to dispense fewer CSPs if they reported that INSPECT provides increased access to patient information. Pharmacists who always use INSPECT refused an average of 25 CSPs annually compared to an average of 7 refusals for pharmacists not using INSPECT. Pharmacists using INSEPCT consistently (at every visit) were 3.3 times more likely to refuse to dispense more CSPs than pharmacists who report never using INSPECT.
  
  
  CONCLUSIONS
  Integration of PDMPs in pharmacy practice may improve a pharmacist's ability to make informed clinical decisions and exercise sound professional judgment. Providing clinical practice tools to both prescribers and pharmacists is important to preventing drug diversion and prescription drug abuse. Future research should focus on understanding the barriers and challenges to successful integration of PDMPs in pharmacy practice.
authors.affiliation: Indiana University Richard M. Fairbanks School of Public Health, 714 N. Senate Ave, Indianapolis, IN 46202, USA; Center for Health Policy, Indiana University Purdue University - Indianapolis, 714 N. Senate Ave, Indianapolis, IN 46202, USA; Health Workforce Studies, Department of Family Medicine, Indiana University School of Medicine, 1110 W. Michigan St., Long Hall 200, Indianapolis, IN 46202, USA. Electronic address: cwnorwoo@iupui.edu.
authors.forename: Connor W
authors.initials: CW
authors.lastname: Norwood
authors.affiliation: Indiana University Richard M. Fairbanks School of Public Health, 714 N. Senate Ave, Indianapolis, IN 46202, USA; Center for Health Policy, Indiana University Purdue University - Indianapolis, 714 N. Senate Ave, Indianapolis, IN 46202, USA; Georgia State University, Department of Sociology, 33 Peachtree Center Ave SE, Langdale Hall Suite 1061, Atlanta, GA 30303, USA.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Wright
mesh_terms: D000328:Adult; D000066491:Clinical Decision-Making; D061891:Controlled Substances; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007196:Indiana; D007600:Judgment; D008297:Male; D008875:Middle Aged; D010593:Pharmaceutical Services / Q000458:organization & administration*; D010595:Pharmacists; D063487:Prescription Drug Misuse / Q000517:prevention & control; D055553:Prescription Drugs
chemical_list: D061891:Controlled Substances; D055553:Prescription Drugs
keywords: Corresponding responsibility; Drug diversion; Opioid addiction; PDMP; Pharmacists; Pharmacy; Pharmacy administration; Prescription drug abuse; Prescription drug monitoring