Prescription Drug Monitoring Programs May Share Data
by George Ochoa
Pharmacy Practice News
To combat prescription drug abuse, prescription drug monitoring programs (PDMPs) have been authorized in 48 states. PDMPs collect and analyze prescribing and dispensing data within a state for enforcement and abuse prevention as well as research and education, according to the Alliance of States with Prescription Monitoring Programs. Now, recently introduced legislation takes the concept a step further. The Interstate Drug Monitoring Efficiency and Data Sharing Act of 2012 (ID MEDS; H.R. 4292, S. 2254) would establish uniform national standards for exchange of information among PDMPs.
Unless states can share information, they can miss individuals who cross state lines to obtain prescription drugs for illicit purposes. “Sharing information across state lines can help physicians identify doctor shoppers [who] may travel to several states to obtain multiple prescriptions for a controlled substance,” Sarah Kelsey, legislative attorney, National Alliance for Model State Drug Laws, Santa Fe, N.M., said in an interview.
ID MEDS was introduced by Sens. Rob Portman (R-Ohio) and Sheldon Whitehouse (D-R.I.) and Reps. Harold Rogers (R-Ky.) and Frank Wolf (R-Va.). “Our bill would strengthen states’ ability to monitor and track prescription drug dispersion, which is a big step forward in the fight to prevent abuse,” said Mr. Portman in a statement. Brian M. Meyer, MBA, director, Government Affairs Division, American Society of Health-System Pharmacists (ASHP), noted in an email that the ASHP House of Delegates passed a policy in 2011 supporting interoperability among state PDMPs, as provided for in the new legislation.
Outpatient Pharmacies Affected
Laws regarding PDMPs vary among states, but in many cases they do not affect the administration of medications to inpatients in hospitals, according to Ms. Kelsey. Mr. Meyer added, “Model legislation from NABP [National Association of Boards of Pharmacy] exempts licensed hospitals for the purpose of inpatient care or the dispensing of a prescription at time of discharge.”
The PDMP in New York “primarily impacts us in our outpatient pharmacy where we comply with [New York state law] just as any pharmacy does,” said Timothy Lesar, PharmD, director of clinical pharmacy services, Albany Medical Center, in Albany, N.Y. “This does not really impact inpatient services.”
Other sources, however, pointed to several potential areas that PDMPs could have a broader impact on hospitals. Jennifer Fass, PharmD, CPh, clinical assistant professor, College of Pharmacy, Nova Southeastern University, in Ft. Lauderdale, Fla., noted that PDMPs can be used by clinicians “to conduct patient searches for those individuals whose care they are directly involved in.” Karl F. Gumpper, RPh, BCPS, FASHP, director, Section of Pharmacy Informatics & Technology, ASHP, said by email that there are several areas in which hospitals could make use of PDMP information, including medication reconciliation, emergency room visits and data access in the case of hospitals with retail pharmacies.
Ms. Kelsey cited another potential in-hospital application of PDMPs: “In an [emergency room] situation, where the doctor likely would not know a patient’s history, a [PDMP] can be a useful tool to assist in determining whether a particular individual may be seeking drugs for a non-legitimate purpose,” she said.
A paper by Dr. Fass and Patrick C. Hardigan, PhD (J Manag Care Pharm 2011;17:430-438) found that both hospital and community pharmacists in Florida were in favor of implementing a PDMP in Florida. Among hospital pharmacists, 74.2% agreed or strongly agreed with the statements that a PDMP “should be implemented in Florida”; similar numbers were reported for chain (84.0%), independent (77.9%) and other (71.1%) pharmacists.
Other Tools for Fighting Abuse
Health-system pharmacies are not limited to the use of PDMPs when it comes to combating prescription drug abuse. “There is usually a sign-off sheet that pharmacy and nursing complete,” Dr. Fass said. “Many of these substances are contained in computer systems … where individuals must log in to administer these substances. Hospitals usually have policies in place to monitor and prevent diversion among health care professionals.” Dr. Lesar added, “We use required chain-of-possession documentation, review of all discrepancies, and statistical data monitoring for unit-based cabinet withdrawal rates.”
Not all states are waiting for legislation to permit information exchange. Two existing platforms allow states to exchange PDMP data: the Prescription Monitoring Information Exchange (PMIX) and the NABP PMP InterConnect. According to Ms. Kelsey, “Some states are already sharing their [PDMP] data and others are working toward doing so.”
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Mr. Gumpper, Ms. Kelsey, Dr. Lesar and Mr. Meyer reported no relevant financial conflicts of interest. Dr. Fass reported a grant from Nova Southeastern University.
by George Ochoa
Pharmacy Practice News
To combat prescription drug abuse, prescription drug monitoring programs (PDMPs) have been authorized in 48 states. PDMPs collect and analyze prescribing and dispensing data within a state for enforcement and abuse prevention as well as research and education, according to the Alliance of States with Prescription Monitoring Programs. Now, recently introduced legislation takes the concept a step further. The Interstate Drug Monitoring Efficiency and Data Sharing Act of 2012 (ID MEDS; H.R. 4292, S. 2254) would establish uniform national standards for exchange of information among PDMPs.
Unless states can share information, they can miss individuals who cross state lines to obtain prescription drugs for illicit purposes. “Sharing information across state lines can help physicians identify doctor shoppers [who] may travel to several states to obtain multiple prescriptions for a controlled substance,” Sarah Kelsey, legislative attorney, National Alliance for Model State Drug Laws, Santa Fe, N.M., said in an interview.
ID MEDS was introduced by Sens. Rob Portman (R-Ohio) and Sheldon Whitehouse (D-R.I.) and Reps. Harold Rogers (R-Ky.) and Frank Wolf (R-Va.). “Our bill would strengthen states’ ability to monitor and track prescription drug dispersion, which is a big step forward in the fight to prevent abuse,” said Mr. Portman in a statement. Brian M. Meyer, MBA, director, Government Affairs Division, American Society of Health-System Pharmacists (ASHP), noted in an email that the ASHP House of Delegates passed a policy in 2011 supporting interoperability among state PDMPs, as provided for in the new legislation.
Outpatient Pharmacies Affected
Laws regarding PDMPs vary among states, but in many cases they do not affect the administration of medications to inpatients in hospitals, according to Ms. Kelsey. Mr. Meyer added, “Model legislation from NABP [National Association of Boards of Pharmacy] exempts licensed hospitals for the purpose of inpatient care or the dispensing of a prescription at time of discharge.”
The PDMP in New York “primarily impacts us in our outpatient pharmacy where we comply with [New York state law] just as any pharmacy does,” said Timothy Lesar, PharmD, director of clinical pharmacy services, Albany Medical Center, in Albany, N.Y. “This does not really impact inpatient services.”
Other sources, however, pointed to several potential areas that PDMPs could have a broader impact on hospitals. Jennifer Fass, PharmD, CPh, clinical assistant professor, College of Pharmacy, Nova Southeastern University, in Ft. Lauderdale, Fla., noted that PDMPs can be used by clinicians “to conduct patient searches for those individuals whose care they are directly involved in.” Karl F. Gumpper, RPh, BCPS, FASHP, director, Section of Pharmacy Informatics & Technology, ASHP, said by email that there are several areas in which hospitals could make use of PDMP information, including medication reconciliation, emergency room visits and data access in the case of hospitals with retail pharmacies.
Ms. Kelsey cited another potential in-hospital application of PDMPs: “In an [emergency room] situation, where the doctor likely would not know a patient’s history, a [PDMP] can be a useful tool to assist in determining whether a particular individual may be seeking drugs for a non-legitimate purpose,” she said.
A paper by Dr. Fass and Patrick C. Hardigan, PhD (J Manag Care Pharm 2011;17:430-438) found that both hospital and community pharmacists in Florida were in favor of implementing a PDMP in Florida. Among hospital pharmacists, 74.2% agreed or strongly agreed with the statements that a PDMP “should be implemented in Florida”; similar numbers were reported for chain (84.0%), independent (77.9%) and other (71.1%) pharmacists.
Other Tools for Fighting Abuse
Health-system pharmacies are not limited to the use of PDMPs when it comes to combating prescription drug abuse. “There is usually a sign-off sheet that pharmacy and nursing complete,” Dr. Fass said. “Many of these substances are contained in computer systems … where individuals must log in to administer these substances. Hospitals usually have policies in place to monitor and prevent diversion among health care professionals.” Dr. Lesar added, “We use required chain-of-possession documentation, review of all discrepancies, and statistical data monitoring for unit-based cabinet withdrawal rates.”
Not all states are waiting for legislation to permit information exchange. Two existing platforms allow states to exchange PDMP data: the Prescription Monitoring Information Exchange (PMIX) and the NABP PMP InterConnect. According to Ms. Kelsey, “Some states are already sharing their [PDMP] data and others are working toward doing so.”
--------------------------------------------------------------------------------
Mr. Gumpper, Ms. Kelsey, Dr. Lesar and Mr. Meyer reported no relevant financial conflicts of interest. Dr. Fass reported a grant from Nova Southeastern University.
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