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Prescription Drug Monitoring Programs are tools that assist healthcare providers in
identifying aberrant opioid use patterns in patients. Researchers from the American College of
Medical Toxicology identified barriers to full utilization of these programs by clinicians. They
provide a glimpse into prescribers’ concerns in a recent New England Journal of Medicine
Philadelphia, PA (PRWEB) May 30, 2012 -- Prescription opioid misuse has reached epidemic levels in the US
and is associated with thousands of deaths each year. Since the vast majority of these drugs, which include
oxycodone (in Percocet) and hydrocodone (in Vicodin), are obtained through prescribing by healthcare
providers, tools must be available that provide reliable information to identify patients who are misusing,
overusing or diverting prescription opioid medications. Prescription drug monitoring programs can help to
identify aberrant practices among patients and in turn provide insight to clinicians prior to prescribing these
potentially dangerous medications. Currently such programs are of variable functionality and simple
enhancements could help to optimize their benefit.
Prescription drug monitoring programs are state-based data collection systems that track prescribing and
dispensing of certain federally scheduled medications, including opioids as well as sedatives like alprazolam
(found in Xanax). Most states allow prescribers to access the system prior to prescribing a controlled
medication and review the patient’s prescription history for signs of aberrancy, as this is often a sign of misuse.
Nearly every state (48/50) has such a system, although they vary widely in functionality and ease of use.
Two researchers from the American College of Medical Toxicology recently examined the opioid prescribing
practices of College members to help determine factors that were considered to be benefits or limitations to
their use of prescription drug monitoring programs. The results were presented at the ACMT national meeting
in March. A glimpse into the prescriber’s concerns is provided in a recent Perspectives article in the New
England Journal of Medicine by the researchers, Jeanmarie Perrone, M.D., from the University of
Pennsylvania, and Lewis Nelson, M.D., from New York University.
They describe the characteristics of the prescription drug monitoring programs that can be frustrating to
clinicians and prevent optimal use of the programs and they recommend ways to create an “ideal” program. The
prescribers studied noted that the major limitation was simply the time to use these programs. According to Dr.
Nelson, “even if it takes only 3 minutes per patient, in a busy emergency department or office practice, having
to do this multiple times daily amounts to a substantial time investment.” As time was the major barrier, several
time-consuming aspects of access were emphasized including navigating to the correct web portal for the
program and recalling and resetting the password. Many clinicians found that once they gained access, timely
information for each patient was not available.
The authors acknowledged that despite these limitations the potential upside of these programs is great, and that
attention is needed toward increasing “user friendliness.” With enhancement, prescription drug monitoring
programs may help to diminish the magnitude of the prescription drug epidemic.
The American College of Medical Toxicology (ACMT) is a professional, nonprofit association of physicians
with recognized expertise in medical toxicology. The College is dedicated to advancing the science and practice
of medical toxicology to improve the care of poisoned patients.
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American College of Medical Toxicology
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