Abstract
ObjectivesTo explore factors and situations that influence pharmacists to use the prescription drug monitoring program (PDMP) and to characterize actions taken by pharmacists after alarming scenarios from a PDMP query. DesignExplanatory sequential 2-phase mixed-methods design: (1) cross-sectional Web-based survey of Washington State pharmacists followed by (2) interviews with purposefully selected respondents to explore statistically significant quantitative findings. Setting and participantsThe study was conducted in Washington State from September 2018 to February 2019. A total of 967 Washington State pharmacists from various practice settings, including inpatient and outpatient pharmacies, participated. Ten outpatient pharmacists were interviewed in the second phase. Outcome measuresThe pharmacists reported the frequency of PDMP use, opinion on the usefulness of PDMP, and action(s) taken after a concerning PDMP report. ResultsThe usable response rate for pharmacists with a PDMP account was 17.6% (818/4659), and usable response rate for all pharmacists was 10.4% (967/9263). PDMP use varied by race, practice setting, and employer policy on PDMP use. Among the 818 PDMP users, 396 (48%) used the database at least once during a shift. Frequent PDMP users were more likely to recommend naloxone compared with less frequent users (adjusted odds ratio 1.70 [95% CI 1.09–2.65], P = 0.02). The following 3 interview themes were identified: time, company policy, and red flags. ConclusionPDMP has value to pharmacists of all practice settings studied. Frequent PDMP use may facilitate more pharmacist interventions, such as a naloxone prescription.
Highlights
The United States is in the middle of a public health crisis of prescription opioid abuse, misuse, overdose, and death.[1,2,3] Over 46 people in the United States die from prescription opioid overdose every day4,5 – a rate that has quadrupled since 2000.6 In parallel, per-capita rates of dispensing prescription opioids tripled from 1999 to 2015.2 The United States uses 80% of the worldwide opioid supply and over 99% of the worldwide hydrocodone supply.[7]
Using the theory of planned behavior (TPB) as the framework, this study examined the contribution of each construct with the addition of perceived obligation in predicting high intention to utilize the prescription drug monitoring programs (PDMP)
This study had three objectives: 1) to explore factors and situations that influence pharmacists to query a patient’s controlled substance prescription history using the PDMP; 2) to characterize actions taken by pharmacists following a concerning report from a PDMP query; and 3) to evaluate the TPB constructs with the addition of perceived obligation in predicting
Summary
The United States is in the middle of a public health crisis of prescription opioid abuse, misuse, overdose, and death.[1,2,3] Over 46 people in the United States die from prescription opioid overdose every day4,5 – a rate that has quadrupled since 2000.6 In parallel, per-capita rates of dispensing prescription opioids tripled from 1999 to 2015.2 The United States uses 80% of the worldwide opioid supply and over 99% of the worldwide hydrocodone supply.[7] The combination of increased opioid use associated with opioid-related morbidity and mortality are key characteristics of the epidemic To combat this epidemic, all 50 states, the District of Columbia, Guam and Puerto Rico have implemented prescription drug monitoring programs (PDMPs) which are state-level databases containing records of dispensed controlled drugs and other drugs with abuse potential. Washington State does not mandate dispenser queries of PDMP.[8]
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