Integration of prescription drug monitoring programs (PDMP) in pharmacy practice: Improving clinical decision-making and supporting a pharmacist's professional judgment

Norwood, Connor W.; Wright, Eric R.

doi:10.1016/j.sapharm.2015.05.008

Cited by 40 publications

(32 citation statements)

References 5 publications

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“…States have varying requirements for PDMP use among pharmacists and prescribers, ranging from voluntary to mandated use [9]. The majority of pharmacists have viewed the PDMP as an objective resource to support clinical decisions, make professional judgements, and prevent diversion and drug abuse [9,32,33,34]. Pharmacists also felt the PDMP helped support patient and prescriber communication regarding suspected drug abuse and helped provide patient education about opioid-specific risks and controlled substance abuse [9,32,35].…”

Section: Resultsmentioning

confidence: 99%

Pharmacist Services in the Opioid Crisis: Current Practices and Scope in the United States

2019

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Introduction: Pharmacist roles promoting safe opioid use are recognized in literature and practice. Pharmacists can offer services such as counseling on opioid risks, naloxone dispensing, education on opioid storage and disposal, prescription drug monitoring program (PDMP) utilization, opioid deprescribing, and providing resources for addiction treatment to help mitigate the opioid crisis. Objective: This commentary seeks to describe current and potential roles for pharmacists to combat the United States opioid crisis and identify key factors affecting service provision. Methods: The paper summarizes evidence-based studies describing current pharmacist roles and services, factors affecting service implementation, and strategies to further improve pharmacist roles and services related to promoting safe opioid use for patients. Results: Pharmacists recognize their roles and responsibilities to counsel patients on opioid risks, dispense naloxone, educate on opioid storage and disposal, utilize prescription drug monitoring programs (PDMPs), offer opioid deprescribing, and provide resources for addiction treatment. However, pharmacists express low confidence, time, and training as barriers to service provision. This suggests a need for structured training, resources, and organizational support for pharmacists to improve confidence and participation in such services. Conclusions: Although pharmacists are aware of roles and responsibilities to help reduce the opioid crisis, more training, education, organizational support and resources are needed to increase their ability to embody these roles.

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Section: Resultsmentioning

confidence: 99%

Pharmacist Services in the Opioid Crisis: Current Practices and Scope in the United States

2019

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“…in the multivariable analysis. 40 Naloxone use was the only significant intervention between frequent and infrequent PDMP users in multivariable analysis, suggesting that the PDMP report may aid the pharmacist in every practice setting to recommend or prescribe naloxone by identifying those who may be at the most significant risk for overdose.…”

Section: Science and Practicementioning

confidence: 98%

Prescription drug monitoring program use and utility by Washington State pharmacists: A mixed-methods study

Pett¹,

Mancl²,

Revere³

et al. 2020

Journal of the American Pharmacists Association

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Objectives: To explore factors and situations that influence pharmacists to use the prescription drug monitoring program (PDMP) and to characterize actions taken by pharmacists after alarming scenarios from a PDMP query. Design: Explanatory sequential 2-phase mixed-methods design: (1) cross-sectional Webbased survey of Washington State pharmacists followed by (2) interviews with purposefully selected respondents to explore statistically significant quantitative findings. Setting and participants: The study was conducted in Washington State from September 2018 to February 2019. A total of 967 Washington State pharmacists from various practice settings, including inpatient and outpatient pharmacies, participated. Ten outpatient pharmacists were interviewed in the second phase. Outcome measures: The pharmacists reported the frequency of PDMP use, opinion on the usefulness of PDMP, and action(s) taken after a concerning PDMP report. Results: The usable response rate for pharmacists with a PDMP account was 17.6% (818/4659), and usable response rate for all pharmacists was 10.4% (967/9263). PDMP use varied by race, practice setting, and employer policy on PDMP use. Among the 818 PDMP users, 396 (48%) used the database at least once during a shift. Frequent PDMP users were more likely to recommend naloxone compared with less frequent users (adjusted odds ratio 1.70 [95% CI 1.09e2.65], P ¼ 0.02). The following 3 interview themes were identified: time, company policy, and red flags. Conclusion: PDMP has value to pharmacists of all practice settings studied. Frequent PDMP use may facilitate more pharmacist interventions, such as a naloxone prescription. Published by Elsevier Inc. on behalf of the American Pharmacists Association.

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“…We found little consensus on the effectiveness of PDMPs.Althoughseveralstudiesfoundnoeffectonopioid prescribing and use after PDMP implementation 21,26,[30][31][32] opioid prescription rates declined in Iowa 39 and pharmacists' self-reported dispensing decreased in Indiana. 36 One study reported a 12.5% reduction in potentially inappropriate opioid prescriptions to Ontario residents with publicly funded drug insurance after implementation of a narcotic drug monitoring program. 27 Several multistate studies showed reductions in opioid prescriptions after PDMP implementation, including a 30% reduction in the self-reported rate of Schedule II prescriptions (opioids with high potential for abuse, such as hydromorphone) among patients reporting pain as a reason for visit 20 a limited decline in days' supply of opioids prescribed among Medicare Part D enrollees, 45 and a reduction in the amount of opioid pills prescribed among persons with disabilities and older adult Medicare enrollees.…”

Section: Impact Of Systems-level Interventions On Opioid Use Overdosmentioning

confidence: 99%

A Rapid Review of the Impact of Systems-Level Policies and Interventions on Population-Level Outcomes Related to the Opioid Epidemic, United States and Canada, 2014-2018

et al. 2020

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Objectives In the United States, rising rates of overdose deaths and recent outbreaks of hepatitis C virus and HIV infection are associated with injection drug use. We updated a 2014 review of systems-level opioid policy interventions by focusing on evidence published during 2014-2018 and new and expanded opioid policies. Methods We searched the MEDLINE database, consistent with the 2014 review. We included articles that provided original empirical evidence on the effects of systems-level interventions on opioid use, overdose, or death; were from the United States or Canada; had a clear comparison group; and were published from January 1, 2014, through July 19, 2018. Two raters screened articles and extracted full-text data for qualitative synthesis of consistent or contradictory findings across studies. Given the rapidly evolving field, the review was supplemented with a search of additional articles through November 17, 2019, to assess consistency of more recent findings. Results The keyword search yielded 535 studies, 66 of which met inclusion criteria. The most studied interventions were prescription drug monitoring programs (PDMPs) (59.1%), and the least studied interventions were clinical guideline changes (7.6%). The most common outcome was opioid use (77.3%). Few articles evaluated combination interventions (18.2%). Study findings included the following: PDMP effectiveness depends on policy design, with robust PDMPs needed for impact; health insurer and pharmacy benefit management strategies, pill-mill laws, pain clinic regulations, and patient/health care provider educational interventions reduced inappropriate prescribing; and marijuana laws led to a decrease in adverse opioid-related outcomes. Naloxone distribution programs were understudied, and evidence of their effectiveness was mixed. In the evidence published after our search’s 4-year window, findings on opioid guidelines and education were consistent and findings for other policies differed. Conclusions Although robust PDMPs and marijuana laws are promising, they do not target all outcomes, and multipronged interventions are needed. Future research should address marijuana laws, harm-reduction interventions, health insurer policies, patient/health care provider education, and the effects of simultaneous interventions on opioid-related outcomes.

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Integration of prescription drug monitoring programs (PDMP) in pharmacy practice: Improving clinical decision-making and supporting a pharmacist's professional judgment

Cited by 40 publications

References 5 publications

Pharmacist Services in the Opioid Crisis: Current Practices and Scope in the United States

Pharmacist Services in the Opioid Crisis: Current Practices and Scope in the United States

Prescription drug monitoring program use and utility by Washington State pharmacists: A mixed-methods study

A Rapid Review of the Impact of Systems-Level Policies and Interventions on Population-Level Outcomes Related to the Opioid Epidemic, United States and Canada, 2014-2018

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