How does use of a prescription monitoring program change pharmacy practice?
How does use of a prescription monitoring program change pharmacy practice?
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DOI：
10.1331/japha.2013.12094
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发表时间：
2013-05-01
影响因子：
2.1
通讯作者：
Friedmann, Peter D.
中科院分区：
文献类型：
--
作者：
Green, Traci C.;Mann, Marita R.;Friedmann, Peter D.
目的：评估两个州（康涅狄格州[CT]和罗得岛[RI]）之间处方监测计划（PMP）使用的差异，探讨PMP在药房实践中的使用，并检查PMP使用与药剂师对疑似转移或“医生购物”的反应之间的关联。“设计：描述性非实验性研究。设置：CT和RI从2011年3月至8月。参与者：在CT和RI的执业药师。干预：匿名调查通过电子邮件发送给pharmistsMain结局措施：PMP的使用，在药房实践中使用患者报告，并对怀疑医生购物或转移的反应。结果：收到了294名药剂师的回复（CT：198; RI：96）。PMP使用者更倾向于使用PMP检测药物滥用（CT：79%; RI：21.9%; P < 0.01）和医生购物（67%; 7%; P < 0.01）。当面对可疑的药物使用行为时，PMP使用者比非使用者更不可能与患者讨论他们的担忧（调整后的比值比0.48 [95% CI 0.25-0.92]），但可能联系提供者（0.86 [0.21-3.47]），将患者转介给开处方者（1.50 [0.79-2.86]），并拒绝填写处方（0.63 [0.30-1.30]）。与非使用者相比，PMP使用者不太可能声称他们没有药物库存（0.27 [0.12-0.60]）。药剂师报告参加继续教育安全配药（72.8%）的高兴趣。结论：药剂师是重要的参与者，努力解决处方药误用和滥用。目前PMP与现行系统的使用对药学实践的影响有限。研究结果指出了未来的研究和需要的实践和教育创新，以提高患者的安全性和更安全的阿片类药物配药药剂师。
Objectives: To assess differences in prescription monitoring program (PMP) use between two states with different PMP accessibility (Connecticut [CT] and Rhode Island [RI]), to explore use of PMPs in pharmacy practice, and to examine associations between PMP use and pharmacists' responses to suspected diversion or "doctor shopping."Design: Descriptive nonexperimental study.Setting: CT and RI from March through August 2011.Participants: Licensed pharmacists in CT and RI.Intervention: Anonymous surveys e-mailed to pharmacistsMain outcome measures: PMP use, use of patient reports in pharmacy practice, and responses to suspected doctor shopping or diversion.Results: Responses from 294 pharmacists were received (CT: 198; RI: 96). PMP users were more likely to use the PMP to detect drug abuse (CT: 79%; RI: 21.9%; P < 0.01) and doctor shopping (67%; 7%; P < 0.01). When faced with suspicious medication use behavior, PMP users were less likely than nonusers to discuss their concerns with the patient (adjusted odds ratio 0.48 [95% CI 0.25-0.92]) but as likely to contact the provider (0.86 [0.21-3.47]), refer the patient back to the prescriber (1.50 [0.79-2.86]), and refuse to fill the prescription (0.63 [0.30-1.30]). PMP users were less likely to state they were out of stock of the drug (0.27 [0.12-0.60]) compared with nonusers. Pharmacists reported high interest in attending continuing education on safe dispensing (72.8%).Conclusion: Pharmacists are important participants in the effort to address prescription drug misuse and abuse. Current PMP use with prevailing systems had limited influence on pharmacy practice. Findings point to future research and needed practice and education innovations to improve patient safety and safer opioid dispensing for pharmacists.