While PDMP use can help to promote safer opioid prescribing, an HHS task force said clinicians should not check the systems too often.
A pain management best practices interagency task force convened by HHS warned clinicians to refrain from relying too heavily on prescription drug monitoring programs to make prescribing decisions in a new report.
Several states mandate that providers query PDMPs at the point of care to identify patients who may be receiving prescriptions from multiple providers, which may indicate a patient is at risk of opioid abuse.
“PDMPs can alert clinicians to provide potentially lifesaving information and interventions,” wrote authors of the report. “The information found in the PDMP can prompt the clinician to take action to improve patient safety by having a conversation about safety concerns and understanding the patient’s goals and needs.”
While PDMP use can enable prescribers to make better-informed clinical decisions, members of the task force urged clinicians to exercise caution when using PDMPs as a tool to aid in medication dispensing. Prescribers engaging in PDMP use often alter their prescribing patterns after accessing patient data.
“PDMPs are not to be used as tools to stop dispensing medications appropriately to those in need,” wrote members of the task force. “For example, it is important for pharmacists to know that doctors often work as teams and to ensure that the conclusion of inappropriate multiple provider use is made only after the pharmacist has communicated directly with the prescribing clinician.”
Physicians, nurses, dentists, and pharmacists concerned about a patients’ opioid use should communicate with one another and relevant state regulatory agencies when appropriate, task force members wrote.
Members of the task force recommended clinicians check PDMPs and other risk stratification tools upon initiating opioid therapy, and then periodically to reevaluate a patient’s opioid use. Task force members also recommended healthcare organizations provide clinician training on accessing and interpreting PDMP data.
After accessing PDMP data, task force members emphasized the importance of clear communication between patients and providers about any potentially concerning information.
“Clinicians should engage patients to discuss their PDMP data rather than making a judgment that may result in the patient not receiving appropriate care,” stated authors in the report. “PDMP data alone are not error proof and should not be used to dismiss patients from clinical practices.”
“If already performed upon admission in the inpatient hospital setting, the health care team should not be mandated to repeatedly check the PDMP if already performed upon admission and pending discharge,” task force members recommended.
Researchers should conduct studies to identify when PDMP data is most useful and adjust PDMP data use according to these findings, report authors wrote.
Ensuring clinicians do not query PDMP databases excessively or make sudden judgments based on PDMP data is key to reducing the risk of patient harm.
In recent years, federal agencies including CMS have pushed prescribers to integrate PDMP use into care delivery.
In 2018, CMS called on state Medicaid programs to enable EHR integration of PDMP data to improve opioid prescribing.
States can receive federal funding to build a PDMP or enhance PDMP functionality per 42 CFR.
PDMPs that are declared specialized registries ready to accept data for the purposes of meaningful use requirements are eligible for this enhanced federal funding and may claim 90 percent HITECH match for costs related to the design, development, implementation, and connection of PDMPs.
CMS encouraged states to use this funding to enhance PDMPs, boost interstate health data exchange, and improve EHR integration of PDMP data.
Date: June 03, 2019
Source: EHR Intelligence