Healthcare practitioner use of real-time prescription monitoring tools: an online survey
Dimi Hoppe A * , Chaojie (George) Liu A and Hanan Khalil
A
+ Author Affiliations
- Author Affiliations
A School of Psychology and Public Health, La Trobe University, Melbourne, Vic. 3000, Australia.
* Correspondence to: D.hoppe@latrobe.edu.au
Australian Health Review 47(2) 208-216 https://doi.org/10.1071/AH22257
Submitted: 8 November 2022 Accepted: 10 December 2022 Published: 12 January 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.
Abstract
Objective The aim of this study is to investigate how healthcare practitioners use real-time prescription monitoring tools in clinical practice.
Methods An online survey was distributed to Australian prescribers and pharmacists who use a real-time prescription monitoring tool. Data were analysed and descriptive statistics summarised participant characteristics and responses. A Chi-squared test was conducted to test the difference between prescribers and pharmacists.
Results The majority of participants agreed that real-time prescription monitoring (RTPM) information is useful (92.2%) and the tool is valuable for informing clinical decisions (90.2%); however, just over half reported that they had changed their prescribing or dispensing practices as a result of RTPM information (51.0%), and they employed evidence-based clinical interventions to varying degrees. No statistically significant differences were detected between pharmacists and prescribers and perceptions on tool use.
Conclusions This is the first known study to investigate practitioner use of RTPM tools in Australia, and is a starting point for further research. What constitutes ‘success’ in the clinical application of RTPM tools is yet to be realised.
Keywords: delivery of health care, health personnel, pharmacists, prescribers, prescription drug misuse, prescription drug monitoring programs, real‐time prescription monitoring.
References
[1] Penington Institute. Australia’s Annual Overdose Report. 2022. Available at https://www.penington.org.au/overdose/overdose-projects-campaigns/australias-annual-overdose-report/ [verified 1 September 2022].[2] Commonwealth of Australia, Department of Health and Aged Care. National Real Time Prescription Monitoring (RTPM). 2022. Available at https://www.health.gov.au/initiatives-and-programs/national-real-time-prescription-monitoring-rtpm [verified 19 October 2022].
[3] Fink DS, Schleimer JP, Sarvet A, et al. Promoting prescription drug monitoring programs for population health: research and policy implications. In: Schepis TS, editor. The prescription drug abuse epidemic: incidence, treatment, prevention, and policy. ABC-CLIO, LLC; 2018.
[4] Islam MM, McRae IS. An inevitable wave of prescription drug monitoring programs in the context of prescription opioids: pros, cons and tensions. BMC Pharmacol Toxicol 2014; 15 46
| An inevitable wave of prescription drug monitoring programs in the context of prescription opioids: pros, cons and tensions.Crossref | GoogleScholarGoogle Scholar |
[5] Government of Western Australia. Department of Health: Medicines and Poisons Regulation Branch. Real time prescription monitoring. 2021. Available at https://ww2.health.wa.gov.au/Articles/N_R/Prescription-monitoring-in-Western-Australia [verified 19 October 2022].
[6] Hoppe D, Karimi L, Khalil H. Mapping the research addressing prescription drug monitoring programs: A scoping review. Drug Alcohol Rev 2022; 41 803–17.
| Mapping the research addressing prescription drug monitoring programs: A scoping review.Crossref | GoogleScholarGoogle Scholar |
[7] Finley EP, Garcia A, Rosen K, et al. Evaluating the impact of prescription drug monitoring program implementation: a scoping review. BMC Health Serv Res 2017; 17 420
| Evaluating the impact of prescription drug monitoring program implementation: a scoping review.Crossref | GoogleScholarGoogle Scholar |
[8] Deyo RA, Hallvik SE, Hildebran C, et al. Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes: A Comparison of Program Users and Nonusers. J Pain 2018; 19 166–77.
| Association of Prescription Drug Monitoring Program Use With Opioid Prescribing and Health Outcomes: A Comparison of Program Users and Nonusers.Crossref | GoogleScholarGoogle Scholar |
[9] Holmgren AJ, Botelho A, Brandt AM. A History of Prescription Drug Monitoring Programs in the United States: Political Appeal and Public Health Efficacy. Am J Public Health 2020; 110 1191–7.
| A History of Prescription Drug Monitoring Programs in the United States: Political Appeal and Public Health Efficacy.Crossref | GoogleScholarGoogle Scholar |
[10] Fraser MR. State Policymaking and Prescription Drug–Monitoring Programs: A Look Ahead. Am J Public Health 2020; 110 1117–8.
| State Policymaking and Prescription Drug–Monitoring Programs: A Look Ahead.Crossref | GoogleScholarGoogle Scholar |
[11] Haffajee RL. Prescription Drug Monitoring Programs — Friend or Folly in Addressing the Opioid-Overdose Crisis? N Engl J Med 2019; 381 699–701.
| Prescription Drug Monitoring Programs — Friend or Folly in Addressing the Opioid-Overdose Crisis?Crossref | GoogleScholarGoogle Scholar |
[12] Young II 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 16
| The current utilization and perceptions of prescription drug monitoring programs among emergency medicine providers in Florida.Crossref | GoogleScholarGoogle Scholar |
[13] Hernandez-Meier JL, Muscott R, Zosel A. The Use of a Statewide Prescription Drug Monitoring Program by Emergency Department Physicians. WMJ 2017; 116 64–8.
[14] Rittenhouse R, Wei F, Robertson D, et al. Utilization of the Arkansas Prescription Monitoring Program to combat prescription drug abuse. Prev Med Rep 2015; 2 524–8.
| Utilization of the Arkansas Prescription Monitoring Program to combat prescription drug abuse.Crossref | GoogleScholarGoogle Scholar |
[15] Blum CJ, Nelson LS, Hoffman RS. A survey of physicians’ perspectives on the New York State mandatory prescription monitoring program (ISTOP). J Subst Abuse Treat 2016; 70 35–43.
| A survey of physicians’ perspectives on the New York State mandatory prescription monitoring program (ISTOP).Crossref | GoogleScholarGoogle Scholar |
[16] Australian Bureau of Statistics. Sample size calculator. 2022. Available at https://www.abs.gov.au/websitedbs/D3310114.nsf/home/Sample+Size+Calculator?opendocument [verified 4 November 2022].
[17] Gosdin MM, Pugliese J, Wintemute G, et al. Philosophical barriers to using prescription drug monitoring programs: Results from a statewide survey. Pain Med 2019; 20 1636–7.
| Philosophical barriers to using prescription drug monitoring programs: Results from a statewide survey.Crossref | GoogleScholarGoogle Scholar |
[18] Fleming ML, Barner JC, Brown CM, et al. Using the theory of planned behavior to examine pharmacists’ intention to utilize a prescription drug monitoring program database. Res Social Adm Pharm 2014; 10 285–96.
| Using the theory of planned behavior to examine pharmacists’ intention to utilize a prescription drug monitoring program database.Crossref | GoogleScholarGoogle Scholar |
[19] Johnston K, Alley L, Novak K, et al. Pharmacists’ attitudes, knowledge, utilization, and outcomes involving prescription drug monitoring programs: A brief scoping review. J Am Pharm Assoc 2018; 58 568–76.
| Pharmacists’ attitudes, knowledge, utilization, and outcomes involving prescription drug monitoring programs: A brief scoping review.Crossref | GoogleScholarGoogle Scholar |
[20] Fendrich M, Bryan JK, Hooyer K. Prescription Drug Monitoring Programs and Pharmacist Orientation Toward Dispensing Controlled Substances. Subst Use Misuse 2018; 53 1324–30.
| Prescription Drug Monitoring Programs and Pharmacist Orientation Toward Dispensing Controlled Substances.Crossref | GoogleScholarGoogle Scholar |
[21] Lin DH, Lucas E, Murimi IB, et al. Physician attitudes and experiences with Maryland’s prescription drug monitoring program (PDMP). Addiction 2017; 112 311–9.
| Physician attitudes and experiences with Maryland’s prescription drug monitoring program (PDMP).Crossref | GoogleScholarGoogle Scholar |
[22] Pugliese JA, Wintemute GJ, Henry SG. Psychosocial correlates of clinicians’ prescription drug monitoring program utilization. Am J Prev Med 2018; 54 e91–8.
| Psychosocial correlates of clinicians’ prescription drug monitoring program utilization.Crossref | GoogleScholarGoogle Scholar |
[23] Tata V, Varisco TJ, Du N, et al. Clinical decision making involving prescription drug monitoring programs: A factorial, vignette-based study among student pharmacists. J Am Pharm Assoc 2021; 61 316–24.
| Clinical decision making involving prescription drug monitoring programs: A factorial, vignette-based study among student pharmacists.Crossref | GoogleScholarGoogle Scholar |
[24] Patel S, Carmichael JM, Taylor JM, et al. Evaluating the Impact of a Clinical Decision Support Tool to Reduce Chronic Opioid Dose and Decrease Risk Classification in a Veteran Population. Ann Pharmacother 2018; 52 325–31.
| Evaluating the Impact of a Clinical Decision Support Tool to Reduce Chronic Opioid Dose and Decrease Risk Classification in a Veteran Population.Crossref | GoogleScholarGoogle Scholar |
[25] Leichtling G, Hildebran C, Novak K, et al. Physician Responses to Enhanced Prescription Drug Monitoring Program Profiles. Pain Med 2020; 21 e9–21.
| Physician Responses to Enhanced Prescription Drug Monitoring Program Profiles.Crossref | GoogleScholarGoogle Scholar |
[26] Carey CM, Meille G, Buchmueller TC. Provider Compliance With Kentucky’s Prescription Drug Monitoring Program’s Mandate To Query Patient Opioid History. Health Aff 2021; 40 461–8.
| Provider Compliance With Kentucky’s Prescription Drug Monitoring Program’s Mandate To Query Patient Opioid History.Crossref | GoogleScholarGoogle Scholar |
[27] Ovadia SA, Garcia O, Thaller SR. Changes in Opioid Prescribing Patterns: A Survey of the Florida Society of Plastic Surgeons. Ann Plast Surg 2020; 85 e54–8.
| Changes in Opioid Prescribing Patterns: A Survey of the Florida Society of Plastic Surgeons.Crossref | GoogleScholarGoogle Scholar |
[28] McAllister MW, Aaronson P, Spillane J, et al. Impact of prescription drug-monitoring program on controlled substance prescribing in the ED. Am J Emerg Med 2015; 33 781–5.
| Impact of prescription drug-monitoring program on controlled substance prescribing in the ED.Crossref | GoogleScholarGoogle Scholar |
[29] Landau A, Lynch M, Callaway C, et al. How are real-time opioid prescribing cognitions by emergency providers influenced by reviewing the state prescription drug monitoring program? Pain Med 2019; 20 955–60.
| How are real-time opioid prescribing cognitions by emergency providers influenced by reviewing the state prescription drug monitoring program?Crossref | GoogleScholarGoogle Scholar |
[30] Martello J, Cassidy B, Mitchell A. Evaluating Emergency Department Opioid Prescribing Behaviors After Education About Mandated Use of the Pennsylvania Prescription Drug Monitoring Program. J Addict Nurs 2018; 29 196–202.
| Evaluating Emergency Department Opioid Prescribing Behaviors After Education About Mandated Use of the Pennsylvania Prescription Drug Monitoring Program.Crossref | GoogleScholarGoogle Scholar |
[31] Norwood CW, Wright ER. Integration of prescription drug monitoring programs (PDMP) in pharmacy practice: Improving clinical decision-making and supporting a pharmacist’s professional judgment. Res Social Adm Pharm 2016; 12 257–66.
| Integration of prescription drug monitoring programs (PDMP) in pharmacy practice: Improving clinical decision-making and supporting a pharmacist’s professional judgment.Crossref | GoogleScholarGoogle Scholar |
[32] Reist J, Frazier J, Rottingham A, et al. Provider beliefs on the Barriers and Facilitators to Prescription Monitoring Programs and Mandated Use. Subst Use Misuse 2020; 55 1–11.
| Provider beliefs on the Barriers and Facilitators to Prescription Monitoring Programs and Mandated Use.Crossref | GoogleScholarGoogle Scholar |
[33] Witry MJ, St. Marie BJ, Viyyuri BR, et al. Factors influencing judgments to consult prescription monitoring programs: a factorial survey experiment. Pain Manag Nurs 2020; 21 48–56.
| Factors influencing judgments to consult prescription monitoring programs: a factorial survey experiment.Crossref | GoogleScholarGoogle Scholar |
[34] Thornton JD, Varisco TJ, Downs CG. Factors associated with the use of the prescription monitoring program by prescribers and pharmacists in Texas. Pharmacoepidemiol Drug Saf 2021; 30 492–503.
| Factors associated with the use of the prescription monitoring program by prescribers and pharmacists in Texas.Crossref | GoogleScholarGoogle Scholar |
[35] Freeman PR, Curran GM, Drummond KL, et al. Utilization of prescription drug monitoring programs for prescribing and dispensing decisions: Results from a multi-site qualitative study. Res Social Adm Pharm 2019; 15 754–60.
| Utilization of prescription drug monitoring programs for prescribing and dispensing decisions: Results from a multi-site qualitative study.Crossref | GoogleScholarGoogle Scholar |
[36] Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016. JAMA 2016; 315 1624–45.
| CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016.Crossref | GoogleScholarGoogle Scholar |
[37] The Royal Australian College of General Practitioners. Prescribing drugs of dependence in general practice, Part C2. The role of opioids in pain management. 2017. Available at https://www.racgp.org.au/FSDEDEV/media/documents/Clinical%20Resources/Guidelines/Drugs%20of%20dependence/Prescribing-drugs-of-dependence-in-general-practice-Part-C2.PDF [verified 25 October 2022].
[38] Busse JW, Craigie S, Juurlink DN, et al. Guideline for opioid therapy and chronic noncancer pain. CMAJ 2017; 189 E659–66.
| Guideline for opioid therapy and chronic noncancer pain.Crossref | GoogleScholarGoogle Scholar |
[39] Commonwealth of Australia, Department of Health and Aged Care. National guidelines for medication-assisted treatment of opioid dependence. 2014. Available at https://www.health.gov.au/resources/publications/national-guidelines-for-medication-assisted-treatment-of-opioid-dependence [verified 25 October 2022].
[40] Commonwealth of Australia, Department of Health and Aged Care. Take home naloxone program. 2022. Available at https://www.health.gov.au/initiatives-and-programs/take-home-naloxone-program [verified 25 October 2022].
[41] Haegerich TM, Jones CM, Cote PO, et al. Evidence for state, community and systems-level prevention strategies to address the opioid crisis. Drug Alcohol Depend 2019; 204 107563
| Evidence for state, community and systems-level prevention strategies to address the opioid crisis.Crossref | GoogleScholarGoogle Scholar |
[42] Fetene DM, Higgs P, Nielsen S, et al. The impact of Victoria’s real time prescription monitoring system (SafeScript) on a cohort of people who inject drugs. Med J Aust 2020; 213 141–141.e1.
| The impact of Victoria’s real time prescription monitoring system (SafeScript) on a cohort of people who inject drugs.Crossref | GoogleScholarGoogle Scholar |
[43] Haines S, Savic M, Picco L, et al. Unintended consequences of using real time prescription monitoring systems. Med J Aust 2020; 213 142–142.e1.
| Unintended consequences of using real time prescription monitoring systems.Crossref | GoogleScholarGoogle Scholar |
[44] Delcher C, Pauly N, Moyo P. Advances in prescription drug monitoring program research: a literature synthesis (June 2018 to December 2019). Curr Opin Psychiatry 2020; 33 326–33.
| Advances in prescription drug monitoring program research: a literature synthesis (June 2018 to December 2019).Crossref | GoogleScholarGoogle Scholar |
[45] Compton WM, Jones CM, Stein JB, et al. Promising roles for pharmacists in addressing the U.S. opioid crisis. Res Social Adm Pharm 2019; 15 910–6.
| Promising roles for pharmacists in addressing the U.S. opioid crisis.Crossref | GoogleScholarGoogle Scholar |
[46] Riley TB, Alemagno S. Pharmacist utilization of prescription opioid misuse interventions: Acceptability among pharmacists and patients. Res Social Adm Pharm 2019; 15 986–91.
| Pharmacist utilization of prescription opioid misuse interventions: Acceptability among pharmacists and patients.Crossref | GoogleScholarGoogle Scholar |
[47] Oldenhof E, Anderson-Wurf J, Hall K, et al. Beyond Prescriptions Monitoring Programs: The Importance of Having the Conversation about Benzodiazepine Use. J Clin Med 2019; 8 2143
| Beyond Prescriptions Monitoring Programs: The Importance of Having the Conversation about Benzodiazepine Use.Crossref | GoogleScholarGoogle Scholar |
[48] Armstrong F, Arunogiri S, Frei MY, et al. The six Rs of managing high-risk opioid prescribing. Aust J Gen Pract 2020; 49 116–20.
| The six Rs of managing high-risk opioid prescribing.Crossref | GoogleScholarGoogle Scholar |
[49] Brown R, Riley MR, Ulrich L, et al. Impact of New York prescription drug monitoring program, I-STOP, on statewide overdose morbidity. Drug Alcohol Depend 2017; 178 348–54.
| Impact of New York prescription drug monitoring program, I-STOP, on statewide overdose morbidity.Crossref | GoogleScholarGoogle Scholar |
[50] Hildebran C, Leichtling G, Irvine JM, et al. Clinical Styles and Practice Policies: Influence on Communication with Patients Regarding Worrisome Prescription Drug Monitoring Program Data. Pain Med 2016; 17 2061–6.
| Clinical Styles and Practice Policies: Influence on Communication with Patients Regarding Worrisome Prescription Drug Monitoring Program Data.Crossref | GoogleScholarGoogle Scholar |
[51] Makdessi CJ, Day C, Chaar BB. Challenges faced with opioid prescriptions in the community setting – Australian pharmacists’ perspectives. Res Social Adm Pharm 2019; 15 966–73.
| Challenges faced with opioid prescriptions in the community setting – Australian pharmacists’ perspectives.Crossref | GoogleScholarGoogle Scholar |
[52] Delcher C, Wang Y, Goodin A, et al. Rapid Expansion of the Opioid Ecosystem: National Implications for Prescriber–Pharmacist Communication. Am J Prev Med 2018; 55 656–61.
| Rapid Expansion of the Opioid Ecosystem: National Implications for Prescriber–Pharmacist Communication.Crossref | GoogleScholarGoogle Scholar |
[53] Hagemeier NE, Tudiver F, Brewster S, et al. Interprofessional prescription opioid abuse communication among prescribers and pharmacists: A qualitative analysis. Subst Abus 2018; 39 89–94.
| Interprofessional prescription opioid abuse communication among prescribers and pharmacists: A qualitative analysis.Crossref | GoogleScholarGoogle Scholar |
[54] Hartung DM, Hall J, Haverly SN, et al. Pharmacists’ Role in Opioid Safety: A Focus Group Investigation. Pain Med 2018; 19 1799–806.
| Pharmacists’ Role in Opioid Safety: A Focus Group Investigation.Crossref | GoogleScholarGoogle Scholar |
[55] Alley L, Novak K, Havlin T, et al. Development and pilot of a prescription drug monitoring program and communication intervention for pharmacists. Res Social Adm Pharm 2020; 16 1422–30.
| Development and pilot of a prescription drug monitoring program and communication intervention for pharmacists.Crossref | GoogleScholarGoogle Scholar |
[56] Chaudhary S, Compton P. Use of risk mitigation practices by family nurse practitioners prescribing opioids for the management of chronic nonmalignant pain. Subst Abus 2017; 38 95–104.
| Use of risk mitigation practices by family nurse practitioners prescribing opioids for the management of chronic nonmalignant pain.Crossref | GoogleScholarGoogle Scholar |
[57] Cook JV, Dickinson HO, Eccles MP. Response rates in postal surveys of healthcare professionals between 1996 and 2005: an observational study. BMC Health Serv Res 2009; 9 160
| Response rates in postal surveys of healthcare professionals between 1996 and 2005: an observational study.Crossref | GoogleScholarGoogle Scholar |
[58] Witry M, Marie BS, Reist J. Provider perspectives and experiences following the integration of the prescription drug monitoring program into the electronic health record. Health Informatics J 2022; 28 14604582221113435
| Provider perspectives and experiences following the integration of the prescription drug monitoring program into the electronic health record.Crossref | GoogleScholarGoogle Scholar |
