Prescription Drug Monitoring: What Every Doctor or Nurse Should Know

By: Mitch Evans

Reading Time: 3 minutes


As prescription opioid use and abuse has surged over the past decade [1], Prescription Drug Monitoring Programs, or PDMPs, have become a cornerstone of state opioid prescribing guidelines in efforts to help promote responsible opioid prescribing. Let’s drill down into the basics of the programs.

Prescription Drug Monitoring PDMP Map.png

What is a Prescription Drug Monitoring Program?

A PDMP is a tool that can be used to address prescription drug diversion and abuse. PDMPs serve multiple functions, including: patient care tool; drug epidemic early warning system; and drug diversion and insurance fraud investigative tool [2].

As a Doctor or Nurse, am I Required to Consult My State’s PDMP?

Providers in the following states are required to consult state PDMPs before prescribing opioid painkillers [3]:

  • Connecticut
  • Kentucky
  • Maryland
  • Massachusetts
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • Ohio
  • Oklahoma
  • Pennsylvania
  • Rhode Island
  • Tennessee
  • West Virginia
  • Wisconsin

The list of states requiring provider consultation is growing quickly (at the time of this post, California’s General Assembly is considering a bill to adopt a mandate [4] ).

In addition, a MACRA proposed rule would give providers high-weighted credit as a part of Clinical Practice Improvement Activities, a score that affects reimbursement from Medicare and Medicaid [5].

Are PDMPs Effective in Preventing Prescription Opioid Abuse and Doctor-Shopping? 

Yes.

A June 2016 Vanderbilt University study [6] concluded that states with robust PDMPs saw a reduction of 1.55 opioid overdose deaths per 100,000. According to Melinda Buntin, Ph.D., professor and Chair of the Department of Health Policy at Vanderbilt, the study “demonstrates that prescription drug monitoring programs can save lives.”

At AffirmHealth, we believe PDMPs are a powerful tool for providers. We develop software to automate the process and deliver actionable intelligence directly to providers, helping them Enhance Patient Care, Ensure Regulatory Compliance, and Keep Their Practice Operating Efficiently.

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[1] http://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf

[2] https://www.ncjrs.gov/pdffiles1/ondcp/pdmp.pdf

[3] http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2016/05/09/states-require-opioid-prescribers-to-check-for-doctor-shopping

[4] http://www.imperial.networkofcare.org/mh/legislate/state-bill-detail.aspx?bill=SB%20482&sessionid=2015000

[5] http://acumenmd.com/blog/clinical-practice-improvement-activities-the-new-kid-on-the-block/

[6] http://news.vanderbilt.edu/2016/06/drug-monitoring-programs-reduce-opioid-deaths-study/

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