Innovations in prescription drug monitoring programs increase their value as a tool to combat the opioid epidemic and offer hope for wider-spread utilization.
As the opioid crisis looms large, prescription monitoring programs (PMPs) have emerged as a growing, state-driven force for intervention. With slight variation in administration and access to data, their existence is now nationwide: 49 states, Washington D.C., and Missouri’s St. Louis County have an established and operational program to collect and track prescribing and dispensing data on designated medications.
Those data — including prescriber, dispenser and patient information as well as information about the prescription itself, including quantity, strength and dates written and filled — can be harnessed by pharmacy and health care prescribers for a number of purposes, including as a deterrent for abuse and diversion, an educational resource and a public health tool to inform prescribing decisions.
Identifying the weaknesses
Yet by 2016, even as a greater number of states opted to share PMP information across state lines through secure data sharing networks and implement mandatory enrollment, a trend was becoming increasingly clear: health care professionals were not fully utilizing the programs. “They just weren’t looking at the data at a rate you would expect,” recalls Dr. Lisa Miller, Head of Corporate Social Responsibility for Purdue Pharma. “We commissioned surveys with health care professionals, and it was revealing to hear them say repeatedly — it’s clunky, it’s time-consuming, it’s not that user-friendly.”
They found that the dilemma was two-fold. First, accessing the PMP disrupted workflow, requiring doctors to step out of the exam room and use their credentials to log-in on a web browser, wasting precious minutes with a patient. Further, when doctors accessed the data, it was presented in an unwieldy, dense and difficult to interpret manner.
Strengthening the program
Purdue set out to seek solutions to these challenges and learn about technology platforms that can integrate PMP data directly into electronic health record or pharmacy dispensing systems. This essentially could provide a practical, clinical decision-making solution by delivering the information to health care practitioners within their clinical work-flow as they’re seeing patients.
These technological advancements can also package the data in a much more user-friendly way, delivering a summary of the findings and employing analytics, scores, red flags and visualizations to indicate various risk-levels. “With these advancements, those data summaries become an important part of decision support,” says Miller. “If you have this information at the time of seeing your patient, it can help coordinate care between a pharmacist and a physician or nurse practitioner as all eyes are on the controlled substance data for the patient.”
A promising test case
In 2017, the Commonwealth of Virginia launched a public-private partnership with Purdue, endeavoring to employ PMP innovations in an effort to boost prescriber and pharmacist utilization of their PMP data. “Our idea was,” Miller explains, “let’s take a look at one state-based PMP demographic, apply all of latest innovations to their system and see if it makes a difference in the utilization rates of PMP’s and ultimately in prescribing and patient care.”
Since the project’s inception in 2017, the utilization rate is already up 205 percent. “We’re very encouraged by Virginia and other states that are taking an innovative, forward-thinking view on how to deliver PMP data,” Miller notes. “We hope that progress will continue on across the nation.”
Early results inspire hope for the great potential of PMPs as they are sharpened and expanded. Through a commitment to research and exploration of these exciting innovations, all states, pharmacies and health care systems have the capacity to adopt smarter PMP utilization practices and increasingly empower doctors with the real-time decision making tools they need to help in addressing opioid abuse.