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Use of a Prescription Drug-Monitoring Program by Emergency and Surgical Prescribers: Results of a Hospital Survey

Abstract

Background

Drug overdoses are the leading cause of death due to injury in the USA. Currently, 49 states have prescription drug-monitoring programs (PDMPs) available to prescribers.

Questions/Purposes

We aimed to assess knowledge and practice of two groups of acute-care prescribers regarding controlled substances.

Methods

A 16-question survey was distributed to a list of surgical and emergency medicine prescribers at our institution. The survey asked about prescriber demographics, previous experiences with a PDMP, and opinions about patient risk factors available within an electronic medical record (EMR).

Results

We received 60 responses (27.1% response rate). All prescribers recognized a growing problem with opioids, both in general and in their own practices, with an average rating of 8.3/10 and 7.9/10, respectively. Although 95% were aware a PDMP was available, only 60% were registered users. Emergency medicine prescribers were significantly more likely to have registered and used the database; 52% said the PDMP was too time-consuming and 23% said the information was not easy to use. All respondents who reported PDMP use indicated it carried some clinical utility, with 87% reporting it to be “somewhat” or “very” useful. Emergency medicine prescribers were more likely to use the PDMP regularly, with 73% selecting “somewhat frequently” or higher, while only 9% of surgery prescribers indicated the same. Of all respondents, 97% agreed that an integrated alert in the existing EMR would be helpful.

Conclusion

Acute-care prescribers at our institution are universally aware of the opioid epidemic, but efficient and useful tools for identifying at-risk patients are lacking. Our prescribers desired an alert system integrated into the EMR to highlight targeted risk factors.

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Acknowledgements

PRIMUM Group (in alphabetical order): Michael Beuhler, MD1, Michael J. Bosse, MD2, Michael Gibbs, MD3, Christopher Griggs, MD3, Steven Jarrett, PharmD4, Michael Runyon, MD3, Animita Saha, MD5, Bradley Watling, MD6, Stephen Wyatt, DO7

1Poison Information Center; Atrium Health, P.O. Box 32861, Charlotte, NC, 28232, USA

2Department Orthopaedic Surgery, Atrium Health Musculoskeletal Institute; 1000 Blythe Boulevard Charlotte, NC, 28203, USA

3Department of Emergency Medicine; Atrium Health, 1000 Blythe Boulevard, Charlotte, NC, 28203, USA

4Patient Safety; Atrium Health, 720 East Morehead Street, Charlotte, NC, 28202, USA

5Department of Internal Medicine; Atrium Heath, 1000 Blythe Boulevard, Charlotte, NC, 28203, USA

6US Acute Care Solutions; Atrium Health, 10628 Park Road, Pineville, NC, 28210, USA

7Department of Behavioral Health; Atrium Health, 1000 Blythe Boulevard, Charlotte, NC, 28203, USA

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Correspondence to Rachel B. Seymour PhD.

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Conflict of Interest

Daniel Leas, MD, Rachel B. Seymour, PhD, Meghan K. Wally, MSPH, Michael Beuhler, MD, Michael J. Bosse, MD, Michael Gibbs, MD, Christopher Griggs, MD, Steven Jarrett, PharmD, Animita Saha, MD, Bradley Watling, MD, and Stephen Wyatt, DO, declare that they have no conflicts of interest. Joseph R. Hsu, MD, reports receiving consulting fees from Acumed and the speaker’s bureau of Smith & Nephew, during the conduct of the study. Michael Runyon, MD, reports receiving research funding from Janssen Pharmaceutical Companies, Boehringer Ingelheim Pharmaceuticals, and Durata Therapeutics International, outside the submitted work.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2013.

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Informed consent was obtained from all subjects included in this study.

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Leas, D., Seymour, R.B., Wally, M.K. et al. Use of a Prescription Drug-Monitoring Program by Emergency and Surgical Prescribers: Results of a Hospital Survey. HSS Jrnl 15, 51–56 (2019). https://doi.org/10.1007/s11420-018-9633-5

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  • DOI: https://doi.org/10.1007/s11420-018-9633-5

Keywords

  • prescription drug-monitoring programs
  • opioid
  • emergency medicine
  • surgeons
  • substance misuse