Prescription monitoring program

In the United States, prescription monitoring programs (PMPs) or prescription drug monitoring programs (PDMPs) are state-run programs which collect and distribute data about the prescription and dispensation of federally controlled substances and, as the individual states deem appropriate, other potentially addictive or abusable prescription drugs. PMPs help to prevent adverse drug events through opioid overdoses, drug diversion, and substance abuse by decreasing the amount and/or frequency of opioid prescribing.[3] A 2017 study found that "US states that have more robust prescription drug monitoring programs have fewer prescription opioid overdose deaths than states with weaker PMPs."[4]

Prescription drug monitoring programs, or PDMPs, are an example of one initiative in place to alleviate effects of the opioid crisis. The programs are designed to restrict prescription drug abuse by limiting a patient’s ability to obtain similar prescriptions from multiple providers (i.e. “doctor shopping”) and reducing diversion of controlled substances. PDMPs may also enable better decision making on the part of healthcare providers.[5]

PDMPs have been implemented in state legislations since 1939 in California, a time before researchers were aware of the highly addictive properties of opioids.[6] Since 2014, 49 states and one US territory have enacted PDMP legislation. Of the 49, 48 have utilized the programs.[7] As of December, 2019, Missouri is the only state within the United States that does not maintain a PMP or PDMP.[8]

Although prescription drug monitoring programs are not new to state legislation, they are constantly being updated for the current healthcare climate. Currently, a major goal is to streamline provider access and improve providers’ understanding of PDMP reports. This is being done by integrating PDMP reports into health information technologies (HITs) such as health information exchanges (HIE), electronic health record (EHR) systems, and/ or pharmacy dispensing software (PDS) systems.[9]

A specific program that has been implemented in nine states is called the PDMP Electronic Health Records Integration and Interoperability Expansion, also known as PEHRIIE. PEHRIIE activities strengthen PDMP utilization by distributing PDMP data and increasing data sharing. Moreover, increasing knowledge of separate effective practices has helped many states reach advancements.[9]

Most health care workers support PMPs[11] which intend to assist physicians, physician assistants, nurse practitioners, dentists and other prescribers, the pharmacists, chemists and support staff of dispensing establishments, as well as law-enforcement agencies. The collaboration supports the legitimate medical use of controlled substances while limiting their abuse and diversion. Pharmacies dispensing controlled substances and prescribers typically must register with their respective state PMPs and (for pharmacies and providers who dispense controlled substances from their offices) report the dispensation to an electronic online database. Some pharmacy software can submit these reports automatically to multiple states.[12]

• Moyo, Patience; Simoni-Wastila, Linda; Griffin, Beth Ann; Onukwugha, Eberechukwu; Harrington, Donna; Alexander, G. Caleb; Palumbo, Francis (October 2017). "Impact of prescription drug monitoring programs (PDMPs) on opioid utilization among Medicare beneficiaries in 10 US States". Addiction. 112 (10): 1784–1796. doi:10.1111/add.13860. PMID 28498498.