How PDMPs Protect Public Health
Prescription drug monitoring programs (or PDMPs) are state-run databases that collect patient-specific prescription information on controlled substances at the point of dispensing. Currently, 49 states, the District of Columbia and the territory of Guam have operational PDMPs. Each PDMP is overseen by a designated agency, and the data are available only to authorized individuals, such as physicians, pharmacists, coroners and law enforcement officials. The data are used to support efforts in education, research, enforcement and abuse prevention and to support the legitimate use of controlled substances. The main goal of PDMPs is to help inform decisions about patient care and create a key intervention point in cases of suspected misuse or abuse. But the information is used for many other reasons, such as Medicaid reviews, cause-of-death investigations, and general research (using de-identified data).
Several studies show PDMPs can be effective sources of information around treatment decisions. For example, a 2010 study found that when PDMP data were used in an emergency room, physicians changed their prescribing in 41% of cases after reviewing the PDMP: 61% of those patients received fewer or no opioid pain medications than had been originally planned by the physician prior to reviewing the PDMP, and 39% received more opioid medication than previously planned because the physician was able to confirm the patient did not have a recent history of controlled substance use.
PDMPs are compelling tools, but critics believe their capability is not fully realized. Many Often PDMPs are not well integrated into electronic patient health records and are be clunky to use. Another problem is that few states share their PDMP data, which is particularly problematic for metropolitan areas that span state borders. And of course, PDMPs cannot reveal if medication is being diverted from a friend or relative (whether knowingly or not). The Substance Abuse and Mental Health Services Administration recently funded a study of nine states to improve the effectiveness and utility of their PDMPs, which resulted in some notable improvements in functionality and data exchange. With further system refinements, PDMPs may help to significantly reduce prescription drug abuse and diversion and their consequences.