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Prescription Drug Monitoring Program: Registration and Use by Prescribers and Pharmacists Before and After Legal Mandatory Registration, California, 2010-2017.

ABSTRACT: OBJECTIVES:To estimate the effect of California's prescription drug monitoring program's (PDMP) registration mandate on use of the PDMP. METHODS:We evaluated the effect of California's mandatory PDMP registration law by fitting time series models on the percentage of clinicians registered for California's PDMP and the percentage of clinicians who were active PDMP users (users who created ??1 patient prescription reports in a given month) from 2010 through 2017. We also compared PDMP use among early PDMP adopters (clinicians who registered >?8 months before the mandatory registration deadline) versus late adopters (clinicians who registered ??8 months before the deadline). RESULTS:Mandatory registration was associated with increases in active PDMP users: 53.5% increase for prescribers and 17.9% for pharmacists. Early adopters were 4 times more likely to be active PDMP users than were late adopters. CONCLUSIONS:Mandatory registration was associated with increases in PDMP registration and use, but most new registrants did not become active users. Public Health Implications. Mandatory PDMP registration increases PDMP use but does not result in widespread PDMP usage by all clinicians prescribing controlled substances.

SUBMITTER: Shev AB

PROVIDER: S-EPMC6236755 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Prescription Drug Monitoring Program: Registration and Use by Prescribers and Pharmacists Before and After Legal Mandatory Registration, California, 2010-2017.

Shev Aaron B AB Wintemute Garen J GJ Cerdá Magdalena M Crawford Andrew A Stewart Susan L SL Henry Stephen G SG

American journal of public health 20181025 12

<h4>Objectives</h4>To estimate the effect of California's prescription drug monitoring program's (PDMP) registration mandate on use of the PDMP.<h4>Methods</h4>We evaluated the effect of California's mandatory PDMP registration law by fitting time series models on the percentage of clinicians registered for California's PDMP and the percentage of clinicians who were active PDMP users (users who created ≥ 1 patient prescription reports in a given month) from 2010 through 2017. We also compared PD ...[more]

PMID: 30359105

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Project description:BackgroundUnder Ontario's Public Hospitals Act, the scope of professional practice of hospital pharmacists is approved by each hospital's medical advisory committee. Some Ontario hospitals have adopted policies or medical directives related to prescription modification, allowing pharmacists to broadly adapt, discontinue, hold, or renew prescriptions as part of their clinical scope of practice.ObjectivesThe primary objective of this study was to describe Ontario hospital pharmacists' perception of their readiness to independently modify prescriptions. The secondary objectives of this study were to gather opinions on the perceived benefits, drawbacks, facilitators, and barriers to prescription modification by pharmacists and to determine how various factors affect perceived readiness.MethodsA confidential web-based survey with Likert-type quantitative questions and qualitative open-ended questions was distributed to 936 hospital pharmacists in Ontario between May and July 2019. Mean scores were calculated for the following constructs affecting prescription modification: self-efficacy, support from the practice environment, and support from interprofessional relationships. Independent t tests were conducted to compare responses between subgroups of interest. The answers to open-ended questions were analyzed thematically.ResultsThe survey had a 29% response rate (n = 271). The mean self-efficacy score was 5.2 out of 7 (standard deviation [SD] 1.0, Cronbach α = 0.88), equivalent to "quite sure". The mean score for support from the practice environment was 3.3 out of 5 (SD 0.4, Cronbach α = 0.75), equivalent to "not a factor". The mean score for support from interprofessional relationships was 4.2 out of 5 (SD 0.1, Cronbach α = 0.80), equivalent to "weak support". Improved efficiency of care, timelier interventions to improve medication safety and efficacy, and improved interprofessional collaboration were cited as benefits of prescription modification by pharmacists. Potential for inappropriate decision-making and miscommunication were cited as concerns. Respondents in hospitals who were already performing prescription modification reported higher self-efficacy to modify prescriptions in clinical areas of both familiarity and unfamiliarity and greater support from prescribers.ConclusionsA large proportion of respondents to a survey of Ontario hospital pharmacists expressed an encouraging level of readiness to independently modify prescriptions. Responses to open-ended questions in this study provided valuable insights to inform widespread adoption of this practice change.

Dataset Information

Prescription Drug Monitoring Program: Registration and Use by Prescribers and Pharmacists Before and After Legal Mandatory Registration, California, 2010-2017.

Publications

Prescription Drug Monitoring Program: Registration and Use by Prescribers and Pharmacists Before and After Legal Mandatory Registration, California, 2010-2017.

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