Skip to main content

Advertisement

Log in

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

  • Opioid Prescribing and Pain Management / Original Article
  • Published:
HSS Journal ®

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Baehren DF, Marco CA, Droz DE, Sinha S, Callan EM, Akpunonu P. A statewide prescription monitoring program affects emergency department prescribing behaviors. Ann Emerg Med. 2010;56(1):19–23.e1–3.

    Article  PubMed  Google Scholar 

  2. Centers for Disease Control and Prevention. Annual surveillance and report of drug-related risks and outcomes—United States, 2017. U.S. Department of Health and Human Services. 2017. Surveillance Special Report 1. Available from https://www.cdc.gov/drugoverdose/pdf/pubs/2017-cdc-drug-surveillance-report.pdf

  3. Centers for Disease Control and Prevention. Policy impact: prescription painkiller overdoses. November 2011. U.S. Department of Health and Human Services. Available from http://www.cdc.gov/drugoverdose/pdf/policyimpact-prescriptionpainkillerod-a.pdf

  4. Chen L, Hedegaard H, Warner M. Drug-poisoning deaths involving opioid analgesics: United States, 1999–2011. NCHS Data Brief. 2014;166:1–8. Available from https://www.cdc.gov/nchs/data/databriefs/db166.pdf

    Google Scholar 

  5. Fink DS, Schleimer JP, Sarvet A, et al. Association between prescription drug monitoring programs and nonfatal and fatal drug overdoses: a systematic review. Ann Intern Med. 2018;168:783–790.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Frenk S, Porter K, Paulozzi L. Prescription opioid analgesic use among adults: United States, 1999–2012. NCHS Data Brief. 2015;189:1–8. Available from https://www.cdc.gov/nchs/data/databriefs/db189.pdf

    Google Scholar 

  7. Hedegaard H, Warner M, Minino AM. Drug overdose deaths in the United States, 1999–2016. NCHS Data Brief. 2017; 294:1–8. Available from https://www.cdc.gov/nchs/data/databriefs/db294.pdf

    Google Scholar 

  8. Hill T. Leveraging Medicaid technology to address the opioid crisis, June 11, 2018. State Medicaid director letter #18–006. Available from https://www.medicaid.gov/federal-policy-guidance/downloads/smd18006.pdf

  9. Lin HC, Wang Z, Boyd C, Simoni-Wastila L, Buu A. Associations between statewide prescription drug monitoring program (PDMP) requirement and physician patterns of prescribing opioid analgesics for patients with non-cancer chronic pain. Addict Behav. 2018;76: 348–354.

    Article  PubMed  Google Scholar 

  10. Losby JL, Hyatt JD, Kanter MH, Baldwin G, Matsuoka D. Safer and more appropriate opioid prescribing: a large healthcare system’s comprehensive approach. J Eval Clin Pract. 2017;23(6):1173–1179.

    Article  PubMed  Google Scholar 

  11. McAllister MW, Aaronson P, Spillane J, et al. Impact of prescription drug-monitoring program on controlled substance prescribing in the ED. Am J Emerg Med. 2015;33:781–785.

    Article  PubMed  Google Scholar 

  12. Prescription Drug Monitoring Program Training and Technical Assistance Center. Prescription drug monitoring frequently asked questions. Available from http://www.pdmpassist.org/content/prescription-drug-monitoring-frequently-asked-questions-faq

  13. Rutkow L, Turner LW, Lucas E, Hwang C, Alexander GC. Most primary care physicians are aware of prescription drug monitoring programs, but many find the data difficult to access. Health Aff (Millwood). 2015;34:484–492.

    Article  Google Scholar 

  14. Seymour RB, Leas D, Wally MK, Hsu JR. Prescription reporting with immediate medication utilization mapping (PRIMUM): development of an alert to improve narcotic prescribing. BMC Med Inform Decis Mak. 2016;16:111.

    Article  PubMed  PubMed Central  Google Scholar 

  15. VanGeest J, Johnson T, Welch V. Methodologies for improving response rates in surveys of physicians: a systematic review. Eval Health Prof. 2007;30:303–321.

    Article  PubMed  Google Scholar 

  16. Warner M, Hedegaard H, Chen L. Trends in drug-poisoning deaths involving opioid analgesics and heroin: United States, 1999–2012. December 2014. Available from http://www.cdc.gov/nchs/data/hestat/drug_poisoning/drug_poisoning.htm

Download references

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

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to Rachel B. Seymour PhD.

Ethics declarations

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.

Informed Consent

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

Required Author Forms:

Disclosure forms provided by the authors are available with the online version of this article.

Electronic supplementary material

ESM 1

(PDF 1224 kb)

ESM 2

(PDF 1224 kb)

ESM 3

(PDF 1224 kb)

ESM 4

(PDF 1224 kb)

ESM 5

(PDF 1225 kb)

ESM 6

(PDF 1224 kb)

ESM 7

(PDF 1224 kb)

ESM 8

(PDF 1224 kb)

ESM 9

(PDF 1239 kb)

ESM 10

(PDF 1225 kb)

ESM 11

(PDF 1239 kb)

ESM 12

(PDF 1224 kb)

ESM 13

(PDF 1224 kb)

Online Resource 1

(PDF 75 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

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

Keywords

Navigation