Prescription Monitoring?

[Besar]

Hi everyone, I work for the Bureau of Education Services and Applied Research at the University of North Dakota. We will be sending out a survey to Nurse Practitioners in an upcoming convention, and would like to hear some information beforehand. Any info your willing to share is greatly appreciated :)

Does anyone practice in a state with a prescription monitoring program? If so, do you access it frequently, and for what purposes?

Do you use the PMP service to investigate a new patient? monitor an existing patient?

Do you consider the information obtained in a patient report to be of value in your day-to-day practice? What could be done to make the program a more useful clinical tool?

Do you discuss information contained in a patient report with your patients in the normal course of treatment?

How does the information contained in a patient report improve patient care?

Do you think being able to see a patient's history of how many prescribers, pharmacists, etc. they have/are using as well as the medications they have been prescribed is important in the treatment of a patient? What are other ways that seeing a patients report could be useful in their care besides identifying drug-seeking patients, or abusers?

Do you consider drug seeking and/or diversion to be a problem? Do you often encounter drug-seeking patients? Is it difficult to identify these individuals, and does information from a patient's report help in this process? Is it likely that you would confront an individual you suspected of drug-seeking and/or drug diversion? Would you rather participate in accidentally prescribing medication to a drug seeker than deny a patient of drugs who truly needs them?

Have you ever denied a patient care due to information contained in their report? Is it likely that you would confront an individual about information contained in their report?

Does your knowledge of a PDMP impact your prescribing practices? Are you more likely to prescribe a safer alternative to a controlled substance?

Do you worry about being investigated for your prescribing habits, or other possible sanctions, due to the PDMP?

Do you think this program is an invasion of privacy to you or your patients?

Do you think a nurse practitioners could potentially abuse the system?

If you do not access information from the PMP, why not? What are the inefficiences of the program that should be addressed?

If your state does not have an operating PMP, do you wish it did? would you use it?

p.s. Also, if you would like more information on the research we are doing I'd be glad to share that as well! :)

Thank you for your time! :)

[traumaRUs, MSN, APRN]

In IL, we have the Department of Health Services PMP website which I check often.

Because of my practice specialty, I do write a fair amt of narcotics. If I am writing for chronic pain pts, I always tell them that I want only one prescriber and only a set amt each month.

I think the federal gov't should require this.

[BCgradnurse, MSN, RN, NP]

I am in MA, and we are in the process of establishing a real time database where prescribers can monitor the controlled substance prescriptions a patient fills. I work in a community with a very high incidence of opiate abuse, and I cannot wait until this tool is up and running. I will use it, believe me. I often encounter patients who are drug seeking. We have an informal communication system with the local ER and pharmacies, and they will often let us know about patients who seem to be drug seeking. I try to refer chronic pain patients to a pain mgmt specialist, but if I rx narcotics I always have patients sign a controlled substance agreement, in which they agree to only get their pain meds from our clinic, and we reserve the right to drug test, have them come in for pill counts, etc. at our discretion. I have had several patients violate these agreements, and I will no longer prescribe for them. I will continue to see them, but will only give non-narcotic medications. I sometimes worry about not treating someone's pain appropriately, but in my clinic I worry far more about contributing to an already out of control opiate problem in the community.

[traumaRUs, MSN, APRN]

In IL, its state-run and includes all scheduled meds. It is covered by HIPAA of course and you do have to register with the site but it is very useful.

[Besar]

Thanks for your replies :) Do you think that there are other potential uses for PDMP other than just identifying drug seeking patients?

[traumaRUs, MSN, APRN]

Yes, you know who is prescribing for your pts. For instance, I work in nephrology but have several pts who have cancer so their oncologist prescribes their pain meds. However, in order for me to prescribe in an emergency, I need to document that I looked at their past scripts and that I discussed their care with their oncologist who manages that aspect.