Researchers at the Heller School for Social Policy and Management assessed PDMPs in a study commissioned by the Pew Health Group. They found a patchwork of strategies and standards, resulting in a reactive approach.
"Being proactive is the key to success in the fight against prescription painkiller abuse," said John L. Eadie, director of the PDMP Center of Excellence at the Heller School. "While doctors may routinely collect and report data to a state program that signals where and when prescription painkillers are likely being misused, the program might not share that information with others who can best use it."
PDMPs are statewide electronic databases that gather information from pharmacies on dispensed prescriptions for controlled substances. There are PDMPs in operation in 41 states, although 49 states have authorized their creation.
The failure of states to analyze the data they collect is seen as one of the key areas that should be addressed. The programs should also "reach out to prescribers, pharmacists, insurers, law enforcement agents, and others who can prevent powerful narcotics from falling into the wrong hands," said Peter Kreiner, principal investigator of the Center of Excellence.
Despite the scarcity of research into PDMPs, the report noted the following best practices:
- Collecting data for all controlled substances such as anti-anxiety medications as well as painkillers. States that do collect data report lower rates of doctor shopping than other states.
- Providing state-issued prescription forms with uniquely configured page numbers. This practice resulted in slower rates of fatal painkiller overdoses.
- Proactively sending alerts about possible abuse to physicians and pharmacists. This was associated with decreased prescription sales and lower rates of doctor shopping.
- Analyzing trend data. This helps law enforcement agencies identify pill mills that illicitly distribute prescription painkillers.
- Boosting doctors' participation in and utilization of the programs. This was associated with reduced fatal prescription painkiller overdoses.
Among the problems cited are differences in the data PDMPs collect, whether and how they ensure data quality, the kinds of data analyses and reports they produce, to which users and under what conditions they make data available, and differences in other procedures and practices, the report noted.
"PDMPs are weakly structured and administered, with an absence of mandatory reporting by physicians and pharmacists, and generally no access for third-party payers," said Leigh Ann Pusey, president and CEO of the American Insurance Association. "More robust reporting and interstate exchange of prescription information, between and among physicians, pharmacies and other third parties with a legitimate policy interest in ending the abuse are desperately needed."
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November 1, 2012
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