Are you familiar with your state Prescription (Drug) Monitoring Program (aka PMP or PDMP)? Is your pain care provider registered and does he/she use it? Have you ever asked? I think it is important for you to be aware of these programs, their purpose and their value when effectively integrated into your pain care plan. Whether you are routinely prescribed controlled medications like opioids for moderate to severe pain for a short time frame or for several months or more, your information is loaded and saved into a state-based database. As of October 2016, 49 of the 50 states in the US, the District of Columbia and Guam, one of the U.S. territories have operational PMPs; only Missouri stands alone.
According to the PDMP Training and Technical Assistance Center out of Brandeis University, “these programs collect, monitor, and analyze electronically transmitted prescribing and dispensing data submitted by pharmacies and dispensing practitioners. The data are used to support states’ efforts in education, research, enforcement and abuse prevention.” In order to protect appropriate medical use of controlled medications, prescription data is provided only to those authorized by state law to access the program, such as healthcare providers who are prescribers, licensed pharmacists, regulatory boards and law enforcement agencies (often with stricter access rules). These rules do vary state by state. For example, in the state of Maryland, your prescriber may designate a trusted staff member of the practice team to have access to your data which allows them to review it and share it with your provider prior to your medical visit. Researchers may be allowed information once your private personal identifiers are removed. Coordinators of county-based Overdose Review Boards may review data of someone who has died from overdose. Law enforcement may access personal data by subpoena when related to an ongoing criminal investigation. States are working on the ability to share data across state lines, which can be helpful when practice settings have patient care loads from multiple states, especially in areas where state borders are close to one another.
PMP information includes key data such as your name and alias’s, your contact information, the name and strengths of prescriptions filled, the amount and date it is filled, who prescribed the medication and what pharmacy dispensed it (unless it was dispensed by the prescriber then that information is included). This information is important for your healthcare provider to know about for many reasons.
It can show:
- If/when you are getting controlled medication(s) from other prescribers which could interfere in your pain treatment
- If the combination of medication filled from another prescriber could potentially cause unsafe side effects from the medications ordered from your pain care provider
- If you are getting medications of the same type from multiple prescribers
- If you are not filling prescriptions.
PMPs can be a valuable safety tool when it is used appropriately and consistently. Most states require pharmacies to load the data as part of the dispensing process. It is interesting that as a next step many states have had to pass laws requiring prescribers of controlled medications to register with their respective PMP. Why? Far too many prescribers failed to voluntarily register and use the information available to them. The reasons for low use are valid. Yes, state PMPs systems need to improve their ease of use and timeliness of information (as close to real time as feasible). Yes, practices need to look at time & staff management issues in order to improve opportunities for data retrieval and review. Yes, interstate state data needs to be easily shared. However, I feel there is a critical, yet overlooked piece—people living with pain who are taking controlled medication need to be informed of their data as it is interpreted into their pain care plan. PMPs can stimulate an excellent point of discussion—a dialogue of what is or is not working in the medication based arena of pain treatment. The data is telling, yet meaningless if not used.
So, at your next visit, before your (controlled medication) prescriptions are completed, how about asking your healthcare provider one simple question:
Are you looking at my PMP data?
I would love to hear what happens next. Give me a shout out in the discussion forum.