Prescription Drug Monitoring Programs
An assessment of the evidence for best practices
The role of state prescription drug monitoring programs (PDMPs) in facilitating appropriate prescribing of controlled prescription drugs and helping to address the prescription drug abuse epidemic has been highlighted in recent studies and in the 2011 White House Office of National Drug Control Policy's Prescription Drug Abuse Prevention Plan (GAO, 2002; Pradel et al., 2009; Baehren et al., 2010; Katz et al., 2010; Johnson et al., 2011; Office of National Drug Control Policy, 2011). A special concern for PDMPs is the diversion of opioid pain relievers into nonmedical use and abuse.
A PDMP is a statewide electronic database that gathers information from pharmacies on dispensed prescriptions for controlled substances (most states that permit practitioners to dispense also require them to submit prescription information to the PDMP). Many PDMPs now provide secure online access to this information for authorized recipients. Prescription data (usually for the past year, and including information on date dispensed, patient, prescriber, pharmacy, medicine, and dose) are made available on request from end users, typically prescribers and pharmacists, and sometimes distributed via unsolicited reports. Recipients of PDMP data may also include practitioner licensure boards, law enforcement and drug control agencies, medical examiners, drug courts and criminal diversion programs, addiction treatment programs, public and private third-party payers, and other public health and safety agencies. States vary widely in which categories of users are permitted to request and receive prescription history reports and under what conditions.
PDMPs represent a substantially underutilized resource in efforts to improve public health outcomes and address prescription drug abuse (Katz et al., 2010). Key reasons for this underutilization include differences in the data PDMPs collect, whether and how they ensure data quality, the kinds of data analyses and reports they produce, to which users and under what conditions they make data available, and differences in an array of other procedures and practices. With respect to many of these practices, there is not widespread understanding of which constitute “best practices”; that is, which practices are associated with maximizing PDMP effectiveness. The purpose of this white paper is to describe what is known about PDMP best practices, describe and assess the evidence supporting their identification as best practices, and document the extent to which PDMPs have implemented these practices.