Australian community pharmacists' experiences of prescription drug monitoring programs: Comparisons between mandated and nonmandated states.

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Prescription drug monitoring programs (PDMPs) track patients' prescription records for high-risk medications and prompt real-time alerts to pharmacists when specific criteria are met. PDMPs are increasingly implemented by health care systems to attempt to mitigate harms associated with prescription opioids. This study aims to explore and compare PDMP experiences among Australian community pharmacists from states where PDMP use is mandated and nonmandated. A representative sample of community pharmacists from New South Wales, Queensland, Victoria, and Western Australia were invited to complete an anonymous online survey. The survey collected pharmacy and pharmacist-related information and asked pharmacists to rank PDMP's usefulness and barriers on a 5-point scale. Mann-Whitney U tests were conducted to determine if there were statistically significant differences in scores between mandated and nonmandated states. In total, 690 pharmacists were included. Pharmacists in mandated states had statistically higher mean 'usefulness' scores for 5 out of 17 items, such as informing clinical decision-making (P<0.001) and increasing confidence to refuse medication supply (P=0.002). PDMP-related barriers were rarely reported by pharmacists, although there were statistically significant differences for specific barriers between mandated and nonmandated states. Nonmandated states had significantly higher mean scores for 5 barriers, including 'unsure what to do with the PDMP information' (P<0.001) and 'PDMP is not integrated into dispensing software' (P=0.005). Mandated states had statistically higher mean scores for 9 barriers, including 'not all scripts appear in PDMP' (P<0.001) and 'inaccurate information in the PDMP' (P<0.001). There were significant differences in pharmacists' PDMP experiences between mandated and nonmandated states, which may have policy implications given Australia's recent investment into national prescription monitoring.