Prescription Drug Monitoring Programs, a Response to Doctor Shopping: Purpose, Effectiveness, and Directions for Future Research

Abstract

Prescription drug abuse is a major worldwide problem and its incidence is on the rise, resulting in a huge societal cost. Prescription drug monitoring programs (PDMPs) are electronic databases that collect data on controlled substances so that health care providers can access the data and deter abuse, doctor shopping, and diversion. Currently only a few countries, including the United States and France, have operational PDMPs. The purpose of this paper is to review the literature on prescription drug monitoring programs. There is a paucity of research articles in this area; only 11 articles were published on this topic and relevant in the last ten years. Four themes were identified, (1) the effect of PDMPs on prescribing practices and the effect of PDMPs on the public, (2) the effect of PDMPs on prescribing practices and multiple provider episodes, (3) the effect of PDMPs on prescribing practices and characteristics of patients, and (4) health care professionals' perspectives on PDMPs. Studies have shown that PDMPs decrease diversion and doctor shopping. Despite implementation of PDMPs, prescription drug rates for controlled substances and abuse rates have risen. There is an urgent need for understanding and research on this topic so that action can be taken.

Prescription drug monitoring program data tracking of opioid addiction treatment outcomes in integrated dual diagnosis care involving injectable naltrexone

“…1C), while being higher in the opioid groups ( F [2,65] = 7.7, p  = .001), declined significantly after the initial injection depending on the diagnostic group (phase× group: F [2,65] = 6.4, p  < .01). Post hoc analyses pinpointed significant declines in opioid prescriptions in only the opioid‐only group (phase: F 1, 18 = 9.7, p  < .01). Opioid pills dispensed/year (Fig.…”

“…PDMPs are important new tools for preventing dangerous addictive drug prescribing, and for diagnosing and treating opioid addictions 11, 18. Our prior study using Indiana's PDMP (INSPECT: INdiana Scheduled Prescription Electronic Collection and Tracking) demonstrated PDMP utility as a diagnostic tool and for identifying detrimental opioid prescribing to mentally ill/addicted patients 11.…”

Unintentional Home Injuries Across the Life Span: Problems and Solutions

“…Preliminary evaluations are under way in several states. Early evaluations demonstrate that these programs have been effective at reducing the diversion of controlled substances (29,42,89,133). For example, policy changes in Florida from 2010 to 2012, which resulted in the shutdown of pain clinics and prescribing dispensers statewide, resulted in a significant decrease in deaths resulting from prescription drug overdoses (65).…”

Misuse of pharmaceuticals by regular psychostimulant users is linked to mental health problems

“…These problems may be severe, as suggested by greater attendance at mental health professionals. Receipt of mental health medication was not significantly related to misuse of the pharmaceuticals, and the pattern of medications received did not align with those misused, suggesting that the visits to MH professionals were not likely to be "doctor shopping" for illicit use (Maxwell, 2011;Worley, 2012). These potential harms were not accounted for by increased frequency of psychostimulant use, suggesting there may be a role in the mental health problems that is specific to the polypharmacy reported by regular "recreational" drug users (Kelly, Wells, Pawson, LeClair, & Parsons, 2014;Smith, Farrell, Bunting, Houston, & Shevlin, 2011;Wilkins et al, 2011).…”