A case for using PDMPs to advance into clinical tools

The opioid abuse epidemic has justly garnered much of the nation’s attention. Reports show that on an average day, 91 deaths occur daily due to opioid-related overdoses in the U.S. As a society, we shoulder $55 billion annually in health and social costs related to prescription opioid abuse. Combine these facts and today we’re facing an incredibly emotionally charged situation that’s also a matter of heated political and social debate. 

At the same time, we as pharmacists know that as severe as this situation is, these cases are the exception versus the rule. More than 650,000 opioid prescriptions are dispensed daily. The vast majority are valid, legitimate prescriptions. Our role is to ensure that people who truly need the medications have access to them.

The true purpose and use of prescription drug monitoring programs (PDMPs) continues to evolve from a tool for law enforcement to identify abuse and diversion, to a clinical tool to help practitioners assess patients more holistically. This seems to be working: the use of PDMPs in 49 states has been linked to the reduction in opioid-related death rates; one study, in particular, specifies that the impact has been one fewer death every two hours on average nationwide. 

As we accumulate and share more data in state PDMP repositories, the data’s potential to transform into a point-of-care clinical tool increases. Most states, for instance, allow prescribers and pharmacists to obtain PDMP reports on patients when a prescription is going to be written or filled for a controlled substance. Our industry has begun to ask such questions as, “Is there value in providers looking at the PDMP information whether they are prescribing an opioid or not?” “Are there data assets that could enhance the clinical relevance of the PDMP data?” “Could predictive analytics assist with providing adherence scoring to potentially detect non-adherence that could lead to addiction?”

The discussion of PDMP transformation would not be complete without touching on a true pain point for practitioners whether prescribing or dispensing – accessing the PDMP data. Gaining access to this data today is outside of the workflow systems, and we still access them manually. Integration of the PDMP data, any other data assets and scoring that will help transform this information into a clinical tool will need to be a real-time pharmacy workflow- and EHR-integrated solution.

We’ve got work to do to get there, but the work that has been done to get these programs in place and the continued focus on improving utilization should be recognized. There is a need for solutions that go beyond displaying lists of transactional data. Enhancing interstate PDMP sharing, and combining the PDMP data with other sources of information for a richer context and more valuable insights while integrating seamlessly into the provider’s and pharmacist’s workflows is the challenge we currently face, but setting a clear goal is half the battle.

When it comes to the opioid epidemic, as a society, we all own it. As an industry and as a profession, we will be part of the solution.


Bobbie Riley, RPh, is the vertical market lead, pharmacy, at LexisNexis Risk Solutions - Health Care
 
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