I-STOP/PMP: A tool for monitoring prescription drug abuse in patients with chronic pain syndromes

Abstract

Background: Patients with chronic pain syndromes often require analgesics and muscle relaxants for symptom management. Unfortunately, many of these agents have abuse potential, and specific concerns have been raised with regard to drug-seeking behaviours that involve multiple clinicians dispensing similar, if not identical, agents. The Internet System for Tracking Over-Prescribing (I-STOP) is a newly implemented law targeted at monitoring the abuse and diversion of controlled substances in New York State. The purpose of this study is to describe the use and the potential for abuse of agents commonly used in the treatment of a variety of urological pelvic pain patients. Materials and methods: Clinical data from 397 patients with interstitial cystitis/bladder pain syndrome (IC/BPS), chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and pelvic floor dysfunction (PFD) were identified through medical record review over a consecutive 6-month period. These names were entered into the Prescription Monitoring Program (PMP) database to which all prescribers have access. I-STOP monitors prescription use over a prior 6-month interval from the date of access. Categoric data were compared with Fisher’s exact test and the chi-square test. Kaplan–Meier product limit curves were stratified by group and compared using the log-rank test. Results: In total, 397 patients with IC/BPS, CP/CPPS, and PFD were included; 14 patients (3.5%) had been prescribed duplicate medications by more than one practitioner. Of those patients who received duplicate prescriptions, 4 of 14 (29%) were for benzodiazepines, and 10 of 14 (71%) of duplicate medications prescribed were opioids. Conclusions: The implementation of the I-STOP/PMP registry provides an innovative way for practitioners to monitor prescribed controlled substances while allowing patients to receive necessary medications for symptom control.