How, why, and for whom do emergency medicine providers use Prescription Drug Monitoring Programs?
| Autor: | Robert J. Smith, Zachary F. Meisel, Austin S. Kilaru, Frances K. Barg, Jeanmarie Perrone, Breah Paciotti, Sarah M. Gadsden |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Prescription Drugs media_common.quotation_subject Alternative medicine Inappropriate Prescribing Grounded theory Article Physicians Surveys and Questionnaires medicine Humans Prescription Drug Monitoring Program Medical prescription Prescription Drug Misuse media_common business.industry Addiction Usability General Medicine Congresses as Topic Middle Aged Substance Abuse Detection Anesthesiology and Pain Medicine Prescription opioid Emergency medicine Emergency Medicine Female Neurology (clinical) Drug Monitoring business Patient education |
| Popis: | Objective The prescription opioid epidemic is currently responsible for the greatest number of unintentional deaths in the United States. One potential strategy for decreasing this epidemic is implementation of state-based Prescription Drug Monitoring Programs (PDMPs), which are designed for providers to identify patients who “doctor shop” for prescriptions. Emergency medicine physicians are some of the most frequent PDMP users and opioid prescribers, but little is known about how they actually use PDMPs, for which patients, and for what reasons. Methods We conducted and transcribed semistructured qualitative interviews with 61 physicians at a national academic conference in October 2012. Deidentified transcripts were entered into QSR NVivo 10.0, coded, and analyzed for themes using modified grounded theory. Results There is variation in pattern and frequency of PDMP access by emergency physicians. Providers rely on both structural characteristics of the PDMP, such as usability, and also their own clinical gestalt impression when deciding to use PDMPs for a given patient encounter. Providers use the information in PDMPs to alter clinical decisions and guide opioid prescribing patterns. Physicians describe alternative uses for the databases, such as improving their ability to facilitate discussions on addiction and provide patient education. Conclusion PDMPs are used for multiple purposes, including identifying opioid misuse and enhancing provider-patient communication. Given variation in practice, standards may help direct indication and manner of physician use. Steps to minimize administrative barriers to PDMP access are warranted. Finally, alternative PDMP uses should be further studied to determine their appropriateness and potentially expand their role in clinical practice. |
| Databáze: | OpenAIRE |
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