Prescription Drug Monitoring Programs (PDMP)
Prescription drug monitoring programs (PDMPs) are electronic databases that keep track of the prescribing and dispensing of controlled prescription drugs. PDMPs are maintained at the state level and are used to identify sources of prescription drug diversion such as visiting numerous primary care providers to obtain prescriptions, forgeries, and improper prescribing or dispensing practices. The PDMP's regulating agency varies by state, with the majority administered by the state's Board of Pharmacy.
Each state varies in which drugs are monitored and who has access to the information. Typically, law enforcement, healthcare professionals, state Medicaid programs, medical examiners or coroners, and some research organizations have access to the information, with most states allowing practitioners and pharmacists to obtain PDMP data about their patients. Having access to PDMP data allows prescribers and pharmacists to see a patient's prescription history and prevent overuse among individuals at risk for opioid use disorder. There is evidence that suggests that PDMPs can alter how drugs are prescribed, particularly opioids.
In 2015, the Centers for Disease Control and Prevention (CDC) provided funds to establish a Prescription Drug Overdose grant program. CDC selected 16 states to receive funding through a competitive application process in their first round and later included an additional 13 states with the highest rates of prescription drug overdose. The program continues through 2019 and states will be awarded with funds between $750,000 and $1 million in order to increase successful prevention efforts.
Examples of Prescription Drug Monitoring Programs
- The Jackson County Data Driven Medico-Justice Practice Improvement pilot program in Jackson County, Oregon, is working to establish an inter-disciplinary action group to create dashboards for primary care providers based on PDMP data. In addition to PDMP data, the group is working to provide education on substance use disorders to community stakeholders and develop a county-wide protocol for the use of naloxone.
- In 2015, Wabanaki Pathway to Hope and Healing, made up of a consortium of five tribal communities in rural Maine partnered with Diversion Alert as part of a naloxone distribution program. Diversion Alert maintains a database of drug arrest data that can be accessed by healthcare professionals in order to respond to patients who may be at risk for overdose, in need of treatment, or illegally selling prescriptions. Diversion Alert also provides tip sheets to providers on how to respond to individuals at risk who may be seeking opioid prescriptions. Wabanaki Pathway to Hope and Healing has worked to create protocols for checking both Diversion Alert and the state PDMP as part of their standard practice.
Considerations for Implementation
While PDMPs may play a crucial role in the prevention of overdose morbidity and mortality, these databases are maintained at a state level which means that local-level agencies may have little input into their design or accessibility. PDMPs are often not accessible in real-time and are not always easy to use. In locations where a state closely borders another state, patients may be able to circumvent identification in a PDMP by filling prescriptions in a neighboring state where prescribers would not have access to interstate-level information. However, the Prescription Drug Monitoring Act introduced into Congress in March 2017 would require states to make their PDMP data available to other states.
Program Clearinghouse Example
Resources to Learn More
PDMP Training and Technical Assistance Center (TTAC)
Provides PDMP reports, recommendations, and trainings. Includes a database of PDMP profiles for each state, with information on which drugs are monitored, data collection frequency, legislation, and other relevant information.
Drug Monitoring Frequently Asked Questions (FAQ)
Provides an overview of PDMPs with links to state-specific information and information on training and technical assistance.
Organization(s): Prescription Drug Monitoring Program Training and Technical Assistance Center
Prescription Drug Monitoring Programs
Provides detailed information for states about PDMP practices and policies. Includes examples of successful implementation in selected states.
Organization(s): Centers for Disease Control and Prevention