How, why, and for whom do emergency medicine providers use prescription drug monitoring programs?
Open accessAbstract
OBJECTIVE: The prescription opioid epidemic is currently responsible for the greatest number of unintentional deaths in the United States. One potential strategy for decreasing this epidemic is implementation of state-based Prescription Drug Monitoring Programs (PDMPs), which are designed for providers to identify patients who "doctor shop" for prescriptions. Emergency medicine physicians are some of the most frequent PDMP users and opioid prescribers, but little is known about how they actually use PDMPs, for which patients, and for what reasons. METHODS: We conducted and transcribed semistructured qualitative interviews with 61 physicians at a national academic conference in October 2012. Deidentified transcripts were entered into QSR NVivo 10.0, coded, and analyzed for themes using modified grounded theory. RESULTS: There is variation in pattern and frequency of PDMP access by emergency physicians. Providers rely on both structural characteristics of the PDMP, such as usability, and also their own clinical gestalt impression when deciding to use PDMPs for a given patient encounter. Providers use the information in PDMPs to alter clinical decisions and guide opioid prescribing patterns. Physicians describe alternative uses for the databases, such as improving their ability to facilitate discussions on addiction and provide patient education. CONCLUSION: PDMPs are used for multiple purposes, including identifying opioid misuse and enhancing provider-patient communication. Given variation in practice, standards may help direct indication and manner of physician use. Steps to minimize administrative barriers to PDMP access are warranted. Finally, alternative PDMP uses should be further studied to determine their appropriateness and potentially expand their role in clinical practice.
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PDMP utilization is not uniform across states and has not yet been integrated into all EMRs.
“It has been shown that PDMP implementation is associated with reduced doctor shopping for prescription opiate painkillers, but PDMP utilization is not uniform across states, and has not yet been integrated into all EMRs (190, 191).”
From A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health (2019) · cites this paper as [191]
PDMP implementation is associated with reduced doctor shopping for prescription opiate painkillers.
“It has been shown that PDMP implementation is associated with reduced doctor shopping for prescription opiate painkillers, but PDMP utilization is not uniform across states, and has not yet been integrated into all EMRs (190, 191).”
From A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health (2019) · cites this paper as [191]
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- Authors
- Smith, R. J., Kilaru, A. S., Perrone, J., Paciotti, B., Barg, F. K., Gadsden, S. M., & Meisel, Z. F.
- Affiliations
- University of Pennsylvania (US)
- Highland Hospital (US)
- Corresponding author
- Meisel, Zachary F.
- Venue
- Pain Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-06
- Volume
- 16
- Issue
- 6
- Pages
- 1122-1131
- ISSN
- 1526-2375 (ISSN-L)
- 1526-4637
- PMC
- PMC4478227
- OpenAlex
- W1925308565
- Cited by
- 62
- References
- 18
- Citations by year
- 2025: 2 · 2023: 2 · 2022: 6 · 2021: 7 · 2020: 9 · 2019: 7 · 2018: 6 · 2017: 6 · 2016: 10 · 2015: 7
- FWCI
- 10.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pain Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Agency for Healthcare Research and Quality (5 R18 HS021956)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- prescription drug monitoring programs, emergency physicians, opioid prescribing, prescription opioid epidemic, opioid misuse, doctor shopping, clinical decision-making, provider-patient communication, patient education, administrative barriers
- MeSH terms
- Adult, Congresses as Topic, Emergency Medicine, Female, Humans, Male, Middle Aged, Physicians, Surveys and Questionnaires, Substance Abuse Detection, Drug Monitoring, Prescription Drugs, Inappropriate Prescribing, Prescription Drug Misuse
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