Physician Responses to Enhanced Prescription Drug Monitoring Program Profiles

• Published in: Pain medicine (Malden, Mass.) Vol. 21; no. 2; pp. e9 - e21
• Main Authors: Leichtling, Gillian, Hildebran, Christi, Novak, Kevin, Alley, Lindsey, Doyle, Sheri, Reilly, Cynthia, Weiner, Scott G
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.02.2020
• Subjects: Adult; Analgesics, Opioid - therapeutic use; Dosage and administration; Drugs; Emergency medical care; Female; Humans; Laws, regulations and rules; Male; Middle Aged; Narcotics; Online health care information services; Opioids; Pain Management; Patient care planning; Patients; Pharmaceutical policy; Physicians; Physicians (General practice); Practice Patterns, Physicians; Prescribing; Prescription Drug Monitoring Programs; Prescription drugs; Primary care; Surveys; Therapeutic drug monitoring; United States; Clinical Decision Support; PDMP; Opioids
• ISSN: 1526-2375; 1526-4637; 1526-4637
• DOI: 10.1093/pm/pny291

Abstract Objective Many states have begun implementing enhancements to PDMP patient profiles such as summaries or graphics to highlight issues of concern and enhance comprehension. The purpose of this study was to examine how physicians respond to sample enhanced PDMP profiles based on patient vignettes. Design Brief semistructured interviews with physicians. Setting Three national medical conferences for targeted specialties. Subjects Ninety-three physicians practicing in primary care, emergency medicine, or pain management. Methods We presented participants with one of three patient vignettes with corresponding standard and enhanced PDMP profiles and conducted brief interviews. Results Findings indicated that enhanced profiles could increase ease of comprehension, reduce time burden, and aid in communicating with patients about opioid risks. Physicians also expressed concern about liability for prescribing when the enhanced profile indicates risk and cautioned against any implication that risk warnings should override clinical judgment based on the patient’s complete medical history or presenting condition. Physicians emphasized the need for transparency of measures and evidence of validation of risk scores. We found little indication that enhanced profiles would change opioid prescribing decisions, though decisions varied by physician. Conclusions Our study underscores the importance of involving prescribers in developing and testing PDMP profile enhancements, as well as providing guidance in the interpretation and clinical use of enhanced profiles. Reduced time burden is an important benefit to consider as the number of states mandating PDMP use increases.