Factors Influencing Judgments to Consult Prescription Monitoring Programs: A Factorial Survey Experiment

Abstract

BackgroundPrescription monitoring programs (PMPs) can provide health care professionals with valuable information. However, few studies have explored providers’ decision making for accessing PMPs. AimsThis study aimed to identify provider characteristics and situational factors most influencing perceived importance of consulting the PMP for patients in a simulated context. DesignThe study used a cross-sectional factorial survey. SettingsThe survey was administered electronically. Participants/SubjectsCommunity pharmacists, advanced practice registered nurses (APRNs), and physicians in Iowa. MethodsParticipants were recruited by mail which included a link to the online survey. The survey consisted of demographic questions, eight randomly generated vignettes, and one ranked item. The vignettes described a hypothetical prescription using eight experimental variables whose levels were randomly varied. Respondents evaluated each vignette for importance to access the PMP. Analyses used linear mixed-effects models in R (Version 3.5.0). ResultsA total of 138 responses were available for multilevel analysis. Women, physicians, and APRNs rated it more important to consult the PMP for a given prescription compared with men and pharmacists. Accessing a PMP was perceived as more important with cash payments, quantity dispensed, suspicion for misuse, hydromorphone and oxycodone prescriptions, and headache. Advancing age, postoperative pain, and anxiety or sleep indications were associated with less importance. ConclusionsAge, indication for prescribing, misuse, and payment mode each independently had greater importance to providers in accessing the PMP. This was the first study to isolate the influence of different controlled substances on how important it was to consult the PMP.