Preliminary analysis of state prescription monitoring programs

Abstract

Prescription Monitoring Programs (PMPs) that are operational in 38 states create state-run electronic databases to track the dispensing of controlled substances. The White House Office of National Drug Control Policy and the Centers for Disease Control have viewed PMPs as important mechanisms for helping clinicians identify high-risk patients. PMPs can provide clinicians critical information about a patient's controlled substance prescription history and alert them to “doctor shoppers” or to persons who take high daily doses of opioid analgesics or are using multiple drugs that have the potential to be abused. Unfortunately, there are no published studies that document the effectiveness of these programs. Here we report preliminary results from a project whose overall objective is to improve the effectiveness of PMPs. We first identified the elements that we believe are essential for a program to be balanced and effective. We then conducted a systematic analysis of state laws and regulations compiled by the National Alliance for Model State Drug Laws to determine if those elements were present in state PMPs or in the legislation that authorizes the creation of PMPs in other states. Our analysis provides empirical evidence of the need for modifications to enhance the effectiveness of existing programs. Only 28% recognize the principle of balance. Very few states provide prescribers or pharmacists real time access (within 24 hours) to information in the data base about current or prospective patients. PMP data are accessible to 74% of health care regulatory boards, but to only 42% of medical assistance programs. We thank Sherry Green, Executive Director of the National Alliance for Model State Drug Laws for her advice and technical support with this work. Funded in part by Purdue Pharma LP and King Pharmaceuticals.