Report: Mandatory PDMP doesn't always work to curb opioid crisis

Given the statistics from Centers for Disease Control and Prevention that 11.5 million people misused prescription opioids, contributing to 40% of all U.S. opioid overdose deaths in 2016, it seems that prescription drug monitoring programs (PDMPs) fit perfectly with efforts to improve safe prescribing practices for patients. But PDMPs don’t always work as intended, according to a report from JAMA Surgery, a monthly professional medical journal.

PDMPs are state-run databases built to identify high-risk patients and prevent opioid overprescriptions from different healthcare facilities, often by integrating electronic medical records with other data sources, such as pharmacy records. Currently, 49 states in the U.S. use PDMPs, with 28 states mandating PDMP enrollment in 2016, according to the Prescription Drug Monitoring Program Training and Technical Assistance Center (TTAC) at Brandeis University.

The Surgery research looked at a 2017 New Hampshire state law that mandated all healthcare professionals conduct a PDMP query and complete an risk assessment for patients receiving outpatient opioid prescriptions for acute pain. According to Surgery, early data indicated that the mandatory program succeeded in decreasing ′′doctor shopping′′ and opioid-related deaths for outpatients with chronic pain.

But there was no significant change in opioid prescription rates among 1,057 patients who underwent surgery before and after the program was mandated in a moderately-sized academic hospital, nor a drop in the mean number of pills prescribed for patients undergoing general surgery. Doctors who have been involved in the program complained that filing the PDMP queries and completing required assessments cost them additional time; only 22% of surgeons supported the idea that PDMP should be mandatory.