Open Access Open Access  Restricted Access Subscription or Fee Access

Trends in Florida's Prescription Drug Monitoring Program registration and utilization: Implications for increasing voluntary use

Chris Delcher, PhD, Yanning Wang, MS, Henry W. Young, MD, Bruce A. Goldberger, PhD, Siegfried Schmidt, MD, PhD, FAAFP, Gary M. Reisfield, MD

Abstract


Objective: Effective use of state prescription drug monitoring programs (PDMPs) to track controlled substance prescribing and dispensing may help mitigate the current opioid crisis. Our objective was to examine trends in registration for and use of Florida's PDMP by physicians and pharmacists, from 2013 to 2016. We discuss implications for PDMP uptake and policy.

Design: Key measures, such as cumulative number of registrants per license type and monthly utilization intensity, are presented. A time series forecasting approach was used to (1) model the monthly count of new PDMP registrants and users from January 2013 to December 2016 and (2) estimate cumulative registration totals after 1 year.

Setting: Florida.

Results: As of November 2016, there were 16,498 physicians (representing 31 percent of Drug Enforcement Administration licensees) and 17,241 pharmacists registered with the PDMP, representing 21 and 57 percent of professional licensees, respectively. Of note, the PDMP's designation as a “specialized registry” for electronic medical record “meaningful use” criteria led to a nearly sevenfold increase in physician registrations in a single month. In November 2016, pharmacists displayed a higher past-month PDMP utilization rate (52.2 percent vs 30.1 percent), while physicians displayed a higher past-month PDMP utilization intensity (58.1 vs. 36.1 queries per user). Approximately 25,000 physicians and 31,000 pharmacists must register by the end of 2017 to meet national policy goals.

Conclusion: PDMP registration among physicians and pharmacists is limited, and the use of the PDMP among registrants is more limited still. Our findings suggest that Florida will not meet national policy goals for registrants by the end of 2017, although new initiatives may alter this trend. Allowing the PDMP to help prescribers meet other professional needs, such as “meaningful use” or similar efforts, may be effective in increasing PDMP use.


Keywords


prescription drug monitoring programs, PDMP, opioid policy, meaningful use, time series

Full Text:

PDF

References


Office of National Drug Control Policy: 2016 National Drug Control Strategy. The White House. Available at https://obamawhitehouse.archives.gov/node/287061. 2016. Accessed January 23, 2017.

The White House, Prescription Opioid Misuse, Heroin, and Fentanyl. 2017. Available at https://www.whitehouse.gov/ondcp/key-issues/prescription-opioid-misuse. Accessed June 28, 2017.

Dasgupta N, Funk MJ, Proescholdbell S, et al.: Cohort study of the impact of high-dose opioid analgesics on overdose mortality. Pain Med. 2016; 17(1): 85-98. doi:10.1111/pme.12907.

Ringwalt C, Schiro S, Shanahan M, et al: The use of a prescription drug monitoring program to develop algorithms to identify providers with unusual prescribing practices for controlled substances. J Prim Prev. 2015; 36(5): 287-299. doi:10.1007/s10935-015-0397-0.

Chang H-Y, Lyapustina T, Rutkow L, et al.: Impact of prescription drug monitoring programs and pill mill laws on high-risk opioid prescribers: A comparative interrupted time series analysis. Drug Alcohol Depend. 2016; 165: 1-8. doi:10.1016/j.drugalcdep.2016.04.033.

The White House, Office of the Press Secretary. FACT SHEET: Obama Administration Announces Public and Private Sector Efforts to Address Prescription Drug Abuse and Heroin Use. 2015. Available at https://www.whitehouse.gov/the-pressoffice/2015/10/21/fact-sheet-obama-administration-announcespublic-and-private-sector. Accessed October 26, 2015.

Haffajee RL, Jena AB, Weiner SG: Mandatory use of prescription drug monitoring programs. JAMA. 2015; 313(9): 891. doi:10.1001/jama.2014.18514.

Deyo RA, Irvine JM, Hallvik SE, et al.: Leading a horse to water: Facilitating registration and use of a prescription drug monitoring program. Clin J Pain. 2014. doi:10.1097/AJP.0000000000000180.

Young HW, Tyndall JA, Cottler LB: The current utilization and perceptions of prescription drug monitoring programs among emergency medicine providers in Florida. Int J Emerg Med. 2017; 10(1). doi:10.1186/s12245-017-0140-0.

Rutkow L, Turner L, Lucas E, et al.: Most primary care physicians are aware of prescription drug monitoring programs, but many find the data difficult to access. Health Aff (Millwood). 2015; 34(3): 484-492. doi:10.1377/hlthaff.2014.1085.

Brandeis University: Enhancing PDMPs: A Comparison of Changes 2010 to 2016. Prescription Drug Monitoring Program Training and Technical Assistance Center, 2016. Available at http://www.pdmpassist.org/pdf/state_survey_comparisons_TAG_final_20161208_3.pdf. Accessed December 21, 2016.

Freeman PR, Goodin A, Troske S, et al.: Kentucky House Bill 1 Impact Evaluation. Institute for Pharmaceutical Outcomes and Policy: University of Kentucky, 2015. Available at http://www.chfs.ky.gov/NR/rdonlyres/8D6EBE65-D16A-448E-80FF-30BED11EBDEA/0/KentuckyHB1ImpactStudyReport03262015.pdf. Accessed February 4, 2016.

Prescription Drug Monitoring Program Center of Excellence: Mandating PDMP Participation by Medical Providers: Current Status and Experience in Selected States. Brandeis University, 2014. Available at http://www.pdmpassist.org/pdf/COE_documents/Add_to_TTAC/COE%20briefing%20on%20mandates%203rd%20revision.pdf. Accessed March 7, 2017.

Christine Vestal: States Require Opioid Prescribers to Check for “Doctor Shopping.” Stateline. 2016. Available at http://pew.org/1Nm27tY. Accessed June 29, 2017.

Dowell D, Haegerich TM, Chou R: CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016. MMWR Recomm Rep. 2016; 65(no. RR-1): 1-49. doi: 10.15585/mmwr.rr6501e1.

Delcher C, Wagenaar AC, Goldberger BA, et al.: Abrupt decline in oxycodone-caused mortality after implementation of Florida's Prescription Drug Monitoring Program. Drug Alcohol Depend. 2015; 150: 63-68. doi:10.1016/j.drugalcdep.2015.02.010.

University of Florida: Florida Drug-Related Outcomes Surveillance and Tracking System (FROST). 2016. Available at http://frost.maples-center.ufl.edu/. Accessed December 21, 2016.

State of California, Department of Justice: California Schedule II-IV Drug Acquisition, Prescription and Dispensation Public Statistics. CURES 2.0 Program. 2015. Available at https://oag.ca.gov/cures/statistics. Accessed December 21, 2016.

Florida Department of Health: 2013-2014 Prescription Drug Monitoring Program Annual Report. 2014. Available at: http://www.floridahealth.gov/statistics-and-data/e-forcse/news-reports/2014-pdmp-annual-report-final.pdf. Accessed January 5, 2015.

Florida Department of Health, Division of Medical Quality Assurance: Health Care Practitioner Data Portal, License Status Download. Available at: https://appsmqa.doh.state.fl.us/downloadnet/licenseStatus.aspx. Accessed May 15, 2016.

Chatfield C: The holt-winters forecasting procedure. J R Stat Soc Ser C Appl Stat. 1978; 27(3): 264. doi:10.2307/2347162.

Dowell D, Haegerich TM, Chou R: CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016. JAMA. 2016; 315(15): 1624. doi:10.1001/jama.2016.1464.

Irvine JM, Hallvik SE, Hildebran C, et al.: Who uses a prescription drug monitoring program and how? Insights from a statewide survey of Oregon clinicians. J Pain. 2014; 15(7): 747-755. doi:10.1016/j.jpain.2014.04.003.

Tavernise S: C.D.C. painkiller guidelines aim to reduce addiction risk. New York Times, 2016. Available at http://www.nytimes.com/2016/03/16/health/cdc-opioid-guidelines.html?_r=0. Accessed June 15, 2016.

The White House, Office of the Press Secretary: Statement by the President on Senate Passage of H.R. 34, the 21st Century Cures Act. 2016. Available at https://www.whitehouse.gov/thepress-office/2016/12/07/statement-president-senate-passage-hr-34-21st-century-cures-act. Accessed December 21, 2016.

Senate Bill 8-A: Medical Use of Marijuana. The Florida Senate. Available at https://www.flsenate.gov/Session/Bill/2017A/00008A. Accessed July 7, 2017.

Florida Department of Health: Using E-FORCSE to Meet Meaningful Use Stage 2 Specialized Registry Objectives. Available at http://www.floridahealth.gov/statistics-and-data/e-forcse/meaningful-use.html. Accessed June 21, 2016.

Centers for Medicare and Medicaid Services: Electronic Health Records Incentive Programs. 2016. Available at: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/EHRincentivePrograms/. Accessed January 11, 2017.

Centers for Medicare and Medicaid Services: Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models. Federal Register. 2016. Available at: https://www.federalregister.gov/documents/2016/11/04/2016-25240/medicare-program-merit-based-incentive-payment-system-mips-and-alternative-payment-model-apm.Accessed January 23, 2017.




DOI: http://dx.doi.org/10.5055/jom.2017.0397

Refbacks

  • There are currently no refbacks.