Concern about the Expanding Prescription Drug Epidemic: A Survey of Licensed Prescribers and Dispensers

Abstract

Background: Prescription drug misuse and abuse has reached epidemic levels in the U.S., and stands as a leading cause of death. As the primary gatekeepers to the medications contributing to this epidemic, it is critical to understand the views of licensed health care professionals. Objective: In this study, we examine health care professionals’ concern regarding prescription drug abuse in their communities and the impact their concern has had on their prescribing and dispensing practices. Study Design: An online survey of licensed health care providers. Setting: Conducted in Indiana. Methods: This study was a state-wide evaluation of Indiana’s prescription drug monitoring program. The questionnaire asked respondents how concerned they were about prescription drug abuse in their community. Variation in the level of concern was examined using ordinary least squares regression and information about the respondents’ demographic background and clinical experience. In addition, we used logistic regression to examine whether concern was associated with changing prescribing and/or dispensing behavior. Results: The majority of providers indicated they were “moderately” or “extremely concerned” about prescription drug abuse in their communities. The level of concern, however, varied significantly by profession, with pharmacists, physicians, nurse practitioners/physician assistants being more concerned than dentists. Additional analyses indicate that providers with higher levels of concern were those who also reported recently changing their prescribing and/ or dispensing behavior. Limitations: The voluntary nature and geographical focus of the study limits the generalizability of the findings. Conclusion: Concern about prescription drug abuse is generally high across the major health care professions; however, a significant minority of providers, particularly among dentists, expressed little or no concern about the epidemic. Increasing health care providers’ general level of concern about prescription drug abuse may be an effective public health tool for encouraging voluntary reductions in prescribing and/or dispensing controlled substances. Key words: Attitudes of physicians, nurse practitioners, physician assistants, and dentists; prescription drug misuse and abuse; prescribing practices; dispensing practices