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Doctors, pharmacists making limited use of prescription-drug database

Posted at 12:05 PM, Nov 20, 2017
and last updated 2017-11-20 07:42:41-05

GAINESVILLE, Fla. (WTXL) - Physicians and pharmacists in Florida are  making only limited use of a statewide database meant to deter prescription drug abuse amid an opioid epidemic in the state, researchers found.

That lack of participation puts Florida at risk of not meeting a federal policy goal of doubling the number of health care providers using the state’s prescription drug monitoring program.

Only 21 percent of doctors and 57 percent of pharmacists had signed up for Florida’s Prescription Drug Monitoring Program, or PDMP, as of November 2016, said University of Florida Health researchers.

Some 25,000 physicians and 31,000 pharmacists in Florida must register by the end of 2017 to meet national policy goals set by then President Barack Obama. The findings were published Monday in the Journal of Opioid Management.

The findings reveal there are new opportunities to encourage physicians to use the database by making them aware of current and future government incentives, said Chris Delcher, an assistant professor in the UF College of Medicine’s Department of Health Outcomes and Policy.

Unlike Florida, 27 states have mandatory database registration. In California, Tennessee and Kentucky, mandated registration resulted in triple-digit percentage increases in registration.

In late September, Gov. Rick Scott proposed that all health-care professionals who prescribe or dispense medication must use the PDMP. The proposal will be discussed when the legislative session begins in January.

For now, Delcher hopes that Scott's declaring the opioid epidemic a public health emergency will help boost the database's use.

"Our focus is mostly on trying to get voluntary buy-in by showing how valuable the database is from a public health perspective," Delcher said.

The latest research was meant to determine whether more physicians and pharmacists were signing up for and using the database between 2013 and 2016, Delcher said. He and his colleagues also projected the probability of meeting federal officials’ PDMP registration goal, which is a few months away.

"We determined that Florida would not be likely to meet that objective in the absence of a statewide change in policy," he said.

Among licensed prescribers, PDMP registration in Florida is voluntary and lags the national average by 9.5 percent. As of November 2016, 16,498 physicians and 17,421 pharmacists were registered to use the Florida database.

Seventy-one percent of physicians and 90.6 percent of pharmacists reported using the database at least once, the researchers found.

There are myriad reasons why more Florida health care providers don’t use the state database, including too little time and the database’s lack of integration with electronic health record systems.

In other cases, some physicians may not use the database because they practice in a specialty where opioid pain medications are less likely to be used, Delcher said.

Other doctors believe they know their patients well enough that checking for overlapping prescriptions isn’t clinically necessary.

Although the latest research doesn’t establish a cause, pharmacists may be using the database more often than physicians because of company rules or practices.

In 2013, The Walgreens Company paid $80 million to resolve federal charges that it didn’t properly control pain medication sales at some stores. That might account for more frequent PDMP use among pharmacists, Delcher said.

Physicians’ use of the database is important for several reasons, including providing a complete record of the patients’ controlled prescription drug use, said Bruce Goldberger, Ph.D., director of UF Health Forensic Medicine and a co-author of the paper.

"Utilization of the PDMP database will reduce prescription drug abuse and reduce drug overdose and death,” he said.

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