Use of PMP may increase demand for drug treatment, reduce painkiller abuse
A Rhode Island Hospital researcher has found that the use of electronic prescription drug monitoring programs (PMPs) may have a significant impact on the demand for drug treatment programs and how prescribers detect and respond to abuse of painkillers. The study by Traci C. Green, Ph.D., MSc, research scientist in Rhode Island Hospital's department of general internal medicine, is published online in advance of print in the journal Pain Medicine.
The study surveyed 1,385 providers in Rhode Island and Connecticut on their use of state PMPs, and found that PMP use was greater in Connecticut where an electronic PMP is available. PMPs are used to gather information about a patient's prescription history, and have the ability to verify patients' self-reported prescription history of abusable medications, aid in the determination of filling multiple prescriptions of the same drug from multiple providers, and assist in the cataloging of medications that may suggest contra-indications or increased risk of adverse events, like overdose.
Both states have reported significant increases in opioid-related death; in fact, overdose has surpassed motor vehicle crashes as the leading cause of unintentional injury death. A national survey indicates that Rhode Island has the highest per capita illicit drug use and ranks third, behind Oklahoma and Oregon, for non-medical use of prescription opioids among persons age 12 or older.
"Prescription drug monitoring programs have historically been oriented to criminal and judicial end users," Green said. "Use of PMPs by prescribers is growing, but how clinicians in actual practice use the data that these systems contain is not well understood."
The researchers surveyed providers in both states who are licensed to prescribe Schedule II medications. These medications have a high potential for abuse, which may lead to severe psychological or physical dependence. Schedule II medications include morphine, Dilaudid, Demerol, oxycodone, fentanyl, and methamphetamine, among others.
The study found that prescribers' use of an electronic PMPs may influence medical care and decisions, especially with opioid abuse detection, and is associated with clinical responses to suspected doctor shopping or diversion. Doctor shopping refers to patients who seek to obtain multiple prescriptions for abusable medications from multiple doctors.
When prescribers suspected a patient of doctor shopping or diverting medications, PMP users were more likely to ramp up clinical monitoring with urine drug screens or refer the patient to drug treatment. PMP users were also less likely to ignore the warning signs or to call law enforcement.
"One thing is clear," Green said, "Clinicians, not law enforcement, have the medical and behavioral health care expertise to guide patients struggling with addiction to get the help they need, when they are ready for it. PMPs can be an important clinical tool to address possible addiction issues and start that conversation."
Green added, "Our study suggests that if states want wider use of PMPs by their prescribers, we need to increase access to drug treatment, especially opioid-dependence treatment options, if we are going to make headway on the epidemic of painkiller abuse and overdose death in our communities."
Since the mid 1990s, there has been a significant nationwide increase in fatal overdose and opioid-related emergency department visits and hospitalizations, driven by a substantial growth in opioid analgesic prescriptions and non-medical use of prescription opioids. Most states report that just 25 percent of their prescribers are using PMPs, and few states require prescribers to check PMPs before dispensing medication.
"PMPs raise the red flags we could be missing on our own," Green said. "They call attention to multiple prescriptions by different doctors, and note contra-indications that put the patient at risk for injury or death. But not enough prescribers are using them. We need to further educate clinicians about these programs, improve drug treatment options and access, and make electronic PMPs more readily available so that this tool can be used most effectively to prevent unnecessary medication-related injury and death."
Provided by Lifespan
- A prescription for excellence Mar 25, 2010 | not rated yet | 0
- Teach prescribers about dangers of long-acting pain meds: FDA Jul 09, 2012 | not rated yet | 0
- Study analyzes link between HIV infection and overdose risk Dec 12, 2011 | not rated yet | 0
- Opioids now most prescribed class of medications Apr 05, 2011 | not rated yet | 0
- New FDA program adds to tools to curb opiod abuse in United States Aug 01, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
How can there be a term called "intestinal metaplasia" of stomach
2 hours ago Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
- More from Physics Forums - Medical Sciences
More news stories
Regardless of pain, social class or age, a woman is more likely to be prescribed pain-relieving drugs. A study published in Gaceta Sanitaria (Spanish health scientific journal) affirms that this phenomenon is inf ...
Medications 32 minutes ago | not rated yet | 0
A new report suggests that improved health care and significant reductions in drug costs might be attained by breaking up the age-old relationship between physicians and drug company representatives who promote the newest, ...
Medications 20 hours ago | 5 / 5 (1) | 0
Federal health regulators say an experimental insomnia drug from Merck can help patients fall asleep, but it also carries worrisome side effects, including daytime drowsiness and suicidal thinking.
Medications 22 hours ago | not rated yet | 0
(AP)—Former Navy Secretary Richard J. Danzig, who has served as a bio-warfare adviser to the president, the Pentagon, and the Department of Homeland Security, urged the government to stockpile an anti-anthrax drug while ...
Medications May 20, 2013 | 5 / 5 (1) | 0
Europe's medicines watchdog said Friday the benefits of acne drug Diane-35, also widely used as a contraceptive, outweigh the risk of developing blood clots in the veins—when correctly prescribed.
Medications May 17, 2013 | not rated yet | 0
In a remote fishing community in Venezuela, a lone fisherman sits on a cliff overlooking the southern Caribbean Sea. This man –– the lookout –– is responsible for directing his comrades on the water, ...
13 minutes ago | not rated yet | 0 |
A novel approach to obstructing the runaway inflammatory response implicated in some types of asthma has shown promise in a Phase IIa clinical trial, according to U. S. researchers.
7 minutes ago | not rated yet | 0
Authorities are investigating rice mills in southern China following tests that found almost half of the staple grain in one of the country's largest cities was contaminated with a toxic metal.
13 minutes ago | not rated yet | 0
Scientists from Nanyang Technological University (NTU) and Lund University, Sweden, have bioengineered a novel molecule which has been proven to successfully kill tumour cells.
22 minutes ago | not rated yet | 0
An article published on the journal Nature describes the major role that Pyruvate dehydrogenase (PDH) —an enzyme of cellular energy metabolism— plays in the regulation of the cellular senescence induce ...
46 minutes ago | not rated yet | 0
Treatment with an Alpha-1 proteinase inhibitor (A1-PI), a naturally occurring protein that protects lung tissue from breakdown and protects the lung's elasticity, is effective in slowing the progression of emphysema in patients ...
5 minutes ago | not rated yet | 0