Prescription drug monitoring programs (PDMPs) are a centerpiece of state efforts to confront the US epidemic of prescription opioid-related morbidity and mortality. However, evidence suggests their full potential has not been realized because of prescriber and pharmacist underuse. PDMPs have been implemented in 49 states to combat prescription drug abuse and improve patient safety, but because pharmacists have little guidance about how to integrate the PDMP into pharmacy practice, PDMPs have not their fulfilled their potential as a clinical decision tool. The long-term goal of this project is to redce opioid-related harms by improving skills and resources available to community pharmacists so they can effectively screen, communicate, and ultimately reduce unsafe opioid dispensing. In response to PA-04-002 (Advancing Patient Safety Implementation through Safe Medication Use), the objective of this study is to develop a community pharmacy PDMP toolkit for identifying patients for whom dispensing an opioid prescription presents a safety risk, communicating with patients at the point of care, and coordinating with the primary prescriber to maximize patient safety in the use of opioid analgesics. Information in the toolkit will enable community pharmacists to integrate the PDMP into their workflow, identify patients at risk for opioid-related harms, approach patients with concerns, and coordinate care with their primary prescribers. The central hypothesis is that enhancing the integration of PDMPs in community pharmacy practice will lead to increased PDMP use and ultimately safer opioid dispensing. This hypothesis will be tested through three specific aims:
The first aim of this study is to develop th PDMP toolkit, including policies and procedures for how community pharmacists can effectively use PDMP at the point of care to increase patient safety and reduce opioid-related harms. Focus groups of pharmacists, prescribers, and patients will inform development of the toolkit.
The second aim i s to implement the PDMP toolkit in six community pharmacies and evaluate the impact of the toolkit on pharmacists' knowledge, attitudes, self-efficacy, and perceptions of opioid dispensing safety.
The third aim i s to evaluate whether implementation of the PDMP toolkit results in safer opioid use. This project is innovative because it challenges pharmacists t elevate their clinical practice with the goal of improving patient safety and reducing opioid- related harms. Upon completion, the developed PDMP toolkit will be immediately available and usable in many community pharmacy settings.

Public Health Relevance

Prescription drug monitoring programs (PDMPs), which operate in 49 states, are a centerpiece of efforts to address the public health crisis of prescription opioid misuse and overdose deaths. Community pharmacists are encouraged to use these programs, but they have little guidance about how to integrate the PDMP into their daily workflow, address troubling prescription patterns with patients, or coordinate care with a patient's primary prescriber. This study aims to develop and pilot test a PDMP toolkit for use in community pharmacies to guide pharmacists' use of the PDMP, with the ultimate goal of reducing prescription opioid- related harms.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Research Demonstration and Dissemination Projects (R18)
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Healthcare Patient Safety and Quality Improvement Research (HSQR)
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Perfetto, Deborah
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Oregon State University
Other Health Professions
Schools of Pharmacy
United States
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Withycombe, Bethany; Ovenell, Mac; Meeker, Amanda et al. (2016) Timing of pivotal clinical trial results reporting for newly approved medications varied by reporting source. J Clin Epidemiol 77:78-83