Capsule Commentary on Radomski et al.’s Physicians’ Perspectives Regarding Prescription Drug Monitoring Program Use Within the Department of Veterans Affairs: a Multi-state Qualitative Study

Capsule Commentary on Radomski et al.’s Physicians’ Perspectives Regarding Prescription Drug... JGIM CAPSULE COMMENTARIES Capsule Commentary on Radomski et al.’s Physicians’ Perspectives Regarding Prescription Drug Monitoring Program Use Within the Department of Veterans Affairs: a Multi-state Qualitative Study 1,2,3 Mark W. Vander Weg, Ph.D. 1 2 3 Iowa City VA Health Care System, Iowa City, IA, USA; Department of Internal Medicine, University of Iowa, Iowa City, IA, USA; Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA. J Gen Intern Med 33(8):1381 Radomski et al.’s rigorous qualitative approach allowed for DOI: 10.1007/s11606-018-4515-6 a greater understanding of factors influencing prescribers’ © Society of General Internal Medicine (This is a U.S. Government work PDMP use. Their findings are consistent with prior work and not under copyright protection in the US; foreign copyright protection suggesting that access difficulties are prominent barriers to may apply) 2018 , 5 their use. Although linking PDMPs to the EMR may raise concerns about information security, it is encouraging that the lthough progress has been made in reducing the amount proposed solutions are feasible and apply to both VA and non- of opioids prescribed in the USA, their use remains VA settings. widespread. To effectively address the morbidity and mortality When designed correctly and used consistently, PDMPs associated with these medications, fundamental changes to the hold considerable promise for improving prescribing practices way that we approach their use are needed. and reducing patient risk. If PDMPs are to fulfill their full One approach receiving increased attention is the use of potential, steps to facilitate their use such as those identified by Prescription Drug Monitoring Programs (PDMPs). Radomski et al. are needed. PDMPs are statewide databases that track the prescribing and dispensing of controlled substances and that are de- Corresponding Author: Mark W. Vander Weg, Ph.D.; Iowa City VA signed to help prescribers and other stakeholders identify Health Care System, Iowa City, IA, USA (e-mail: mark- and prevent their misuse. Although evaluations of their vanderweg@uiowa.edu). impact have yielded mixed results, accumulating evidence suggests that state PDMPs with robust features including Compliance with ethical standards: strong mandates regarding registration and use are associ- Conflict of interest: The author declares that he has no conflict of ated with reductions in opioid prescribing and overdose interest. deaths. Unfortunately, PDMPs remain greatly underutilized, which substantially undermines their potential impact. To help un- REFERENCES derstand why, Radomski et al. investigated the Department of 1. Radomski TR, Bixler FR, Zickmund SL, Roman KM, Thorpe CT, Hale Veterans Affairs (VA) physicians’ perspectives regarding JA, Sileanu FE, Hausmann LRM, Thorpe JM, Suda KJ, Stroupe KT, PDMPs. Primary care providers from states with differing Gordon AJ, Good CB, Fine MJ, Gellad WF. Physicians’ Perspectives levels of prescriber access to PDMPs were interviewed regard- Regarding Prescription Drug Monitoring Program Use within the Depart- ment of Veterans Affairs: A Multi-State Qualitative Study. J Gen Intern ing their experiences with PDMPs as well as barriers and Med. DOI: https://doi.org/10.1007/s11606-018-4374-1. facilitators to their use. Although support for PDMPs was 2. Wen H, Shackman BR, Aden B, Bao Y. States with Prescription Drug Monitoring Mandates Saw a Reduction in Opioids Prescribed to Medicaid widespread, difficulties accessing key information and signif- Enrollees. Health Affairs. 2017;36(4):733–41. icant administrative burdens were noted. Limited availability 3. Patrick SW, Fry CE, Jones TF, Buntin MB. Implementation of Prescrip- of VA prescription data in state PDMPs was also viewed as tion Drug Monitoring Programs Associated with Reductions in Opioid- related Death Rates. Health Affairs. 2016;35(7):1324–32. problematic. Linking PDMPs to the electronic medical record 4. Rutkow L, Turner L, Lucas E, Hwang C, Alexander GC.Most Primary (EMR), access to note templates to facilitate documentation, Care Physicians are Aware of Prescription Drug Monitoring Programs, but Many Find the Data Difficult to Access. Health Affairs. 2015;34(3):484–92. and the ability to delegate routine queries to ancillary staff 5. Poon SJ, Greenwood-Ericksen MB, Gish RE, Neri PM, Takhar SS, were identified as desired modifications to enhance usability. Weiner SG, Schuur JD, Landman AB. Usability of the Massachusetts Prescription Drug Monitoring Program in the Emergency Department: A Published online June 4, 2018 Mixed-methods Study. Acad Emerg Med. 2016 Apr;23(4):406–14. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of General Internal Medicine Springer Journals

Capsule Commentary on Radomski et al.’s Physicians’ Perspectives Regarding Prescription Drug Monitoring Program Use Within the Department of Veterans Affairs: a Multi-state Qualitative Study

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Society of General Internal Medicine (This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply)
Subject
Medicine & Public Health; Internal Medicine
ISSN
0884-8734
eISSN
1525-1497
D.O.I.
10.1007/s11606-018-4515-6
Publisher site
See Article on Publisher Site

Abstract

JGIM CAPSULE COMMENTARIES Capsule Commentary on Radomski et al.’s Physicians’ Perspectives Regarding Prescription Drug Monitoring Program Use Within the Department of Veterans Affairs: a Multi-state Qualitative Study 1,2,3 Mark W. Vander Weg, Ph.D. 1 2 3 Iowa City VA Health Care System, Iowa City, IA, USA; Department of Internal Medicine, University of Iowa, Iowa City, IA, USA; Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA. J Gen Intern Med 33(8):1381 Radomski et al.’s rigorous qualitative approach allowed for DOI: 10.1007/s11606-018-4515-6 a greater understanding of factors influencing prescribers’ © Society of General Internal Medicine (This is a U.S. Government work PDMP use. Their findings are consistent with prior work and not under copyright protection in the US; foreign copyright protection suggesting that access difficulties are prominent barriers to may apply) 2018 , 5 their use. Although linking PDMPs to the EMR may raise concerns about information security, it is encouraging that the lthough progress has been made in reducing the amount proposed solutions are feasible and apply to both VA and non- of opioids prescribed in the USA, their use remains VA settings. widespread. To effectively address the morbidity and mortality When designed correctly and used consistently, PDMPs associated with these medications, fundamental changes to the hold considerable promise for improving prescribing practices way that we approach their use are needed. and reducing patient risk. If PDMPs are to fulfill their full One approach receiving increased attention is the use of potential, steps to facilitate their use such as those identified by Prescription Drug Monitoring Programs (PDMPs). Radomski et al. are needed. PDMPs are statewide databases that track the prescribing and dispensing of controlled substances and that are de- Corresponding Author: Mark W. Vander Weg, Ph.D.; Iowa City VA signed to help prescribers and other stakeholders identify Health Care System, Iowa City, IA, USA (e-mail: mark- and prevent their misuse. Although evaluations of their vanderweg@uiowa.edu). impact have yielded mixed results, accumulating evidence suggests that state PDMPs with robust features including Compliance with ethical standards: strong mandates regarding registration and use are associ- Conflict of interest: The author declares that he has no conflict of ated with reductions in opioid prescribing and overdose interest. deaths. Unfortunately, PDMPs remain greatly underutilized, which substantially undermines their potential impact. To help un- REFERENCES derstand why, Radomski et al. investigated the Department of 1. Radomski TR, Bixler FR, Zickmund SL, Roman KM, Thorpe CT, Hale Veterans Affairs (VA) physicians’ perspectives regarding JA, Sileanu FE, Hausmann LRM, Thorpe JM, Suda KJ, Stroupe KT, PDMPs. Primary care providers from states with differing Gordon AJ, Good CB, Fine MJ, Gellad WF. Physicians’ Perspectives levels of prescriber access to PDMPs were interviewed regard- Regarding Prescription Drug Monitoring Program Use within the Depart- ment of Veterans Affairs: A Multi-State Qualitative Study. J Gen Intern ing their experiences with PDMPs as well as barriers and Med. DOI: https://doi.org/10.1007/s11606-018-4374-1. facilitators to their use. Although support for PDMPs was 2. Wen H, Shackman BR, Aden B, Bao Y. States with Prescription Drug Monitoring Mandates Saw a Reduction in Opioids Prescribed to Medicaid widespread, difficulties accessing key information and signif- Enrollees. Health Affairs. 2017;36(4):733–41. icant administrative burdens were noted. Limited availability 3. Patrick SW, Fry CE, Jones TF, Buntin MB. Implementation of Prescrip- of VA prescription data in state PDMPs was also viewed as tion Drug Monitoring Programs Associated with Reductions in Opioid- related Death Rates. Health Affairs. 2016;35(7):1324–32. problematic. Linking PDMPs to the electronic medical record 4. Rutkow L, Turner L, Lucas E, Hwang C, Alexander GC.Most Primary (EMR), access to note templates to facilitate documentation, Care Physicians are Aware of Prescription Drug Monitoring Programs, but Many Find the Data Difficult to Access. Health Affairs. 2015;34(3):484–92. and the ability to delegate routine queries to ancillary staff 5. Poon SJ, Greenwood-Ericksen MB, Gish RE, Neri PM, Takhar SS, were identified as desired modifications to enhance usability. Weiner SG, Schuur JD, Landman AB. Usability of the Massachusetts Prescription Drug Monitoring Program in the Emergency Department: A Published online June 4, 2018 Mixed-methods Study. Acad Emerg Med. 2016 Apr;23(4):406–14.

Journal

Journal of General Internal MedicineSpringer Journals

Published: Jun 4, 2018

References

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