5D Investigation of Decision-making in Prescription Drug Monitoring Program Use: A Factorial Survey Experiment

Abstract

The National Institute on Drug Abuse has stated that the increase in availability of prescription opioids for the treatment of pain has contributed to the rise in opioid misuse and diversion. In response to this increase, states have implemented Prescription Drug Monitoring Programs (PDMPs) so that healthcare providers can access the controlled substance prescription history of their patients. There is some evidence that PDMPs have been successful in decreases in deaths from overdose. The goals of PDMPs are to reduce opioid abuse, decrease opioid diversion, and help identify when substance treatment is warranted. The purpose of this presentation is to provide preliminary data on a study is to determine what factors most influence a health care provider's decision to consult the Prescription Drug Monitoring Program database (PDMP). Currently, in most states, it is the provider's discretion on when to consult the PDMP for prescribing or dispensing controlled substances. There is a gap in knowledge about the circumstances that lead to PDMP use, including the role implicit biases plays in determining access of the PDMP prior to prescribing or dispensing opioids for pain. The clinical significance of this study is that implicit biases and other subconscious decision-making process could be contributing to health disparities in how controlled substances are prescribed and used. Basic research on patient and provider characteristics associated with PDMP, and provider decision-making is needed to identify if there are implicit biases and what they are. With this knowledge, training and policy changes could be implemented to address non-clinical variation in PDMP use.