How does use of a prescription monitoring program change pharmacy practice?

Background: Prescription monitoring programs (PMPs) can influence risks associated with abuseable medications. Limited data exist on affects of PMP use on pharmacy practice. We aimed to test for differences in PMP use between two states, Connecticut (CT) and Rhode Island (RI), with different PMP accessibility; to explore use of PMPs in pharmacy practice; and to examine associations between PMP use and pharmacist's responses to suspected diversion or “doctor shopping”.

Methods: Anonymous surveys were emailed to CT and RI licensed pharmacists (CT n=4600, RI n=1731). Data were collected March through August 2011.

Results: Responses from 294 pharmacists were received (CT: 198, RI: 96). PMP users were more likely to use the PMP to detect doctor shopping (CT: 67%, RI: 7%, p<0.001). When faced with suspicious medication use behavior, PMP users were less likely than non-users to discuss their concerns with the patient (aOR 0.48 [0.25, 0.92]) but as likely to contact the provider (aOR 0.86 [0.21, 3.47]), refer the patient back to the prescriber (aOR 1.50 [0.79, 2.86]), and refuse to fill the prescription (aOR 0.63 [0.30, 1.30]). PMP users were less likely to state they were out of stock of the drug (aOR 0.27 [0.12, 0.60]) compared to non-users. Pharmacists reported high interest in attending continuing education on safe dispensing (79%). Conclusions: PMP use had minimal influence on pharmacy practice. PMP users were less likely to discuss concerns with patients, which may be of concern for opioid abuse and overdose risks. Patient safety and safe dispensing education opportunities for pharmacist are indicated.