How to Use the Prescription Drug Monitoring Program Henrique Pedro, RPh, Lifespan Pharmacy
Disclosures and Slide/Content Credits No Disclosures to Report This talk represents my individual opinions and does not necessarily represent the opinions of Lifespan Pharmacy. Credit and thank you to the Rhode Island Department of Health and Dr. James McDonald for the content of all the slides.
Provider Log In Screen If you are not registered, join the family now If you like Users’ Manuals: http://health.ri.gov/ publications/guides/ HowToUseThePDMP.pdf
Prescriber-Oriented Dashboard Patient-centered alerts • Recent request history • • Delegate ability to get into PMP to others in the office • Prescriber-specific announcements
Patient Request Information States you can also check are listed here: In RI can see MA, CT, NH plus others
Patient Rx Request Patient Match Found • Getting complete results may require review and approval by the state PMP Administrator. If necessary , a message with further instructions will display. No Matching Patient Identified : No patient was found who matched criteria entered. • Check the patient information entered for accuracy • Enter additional information (ZIP code) to enhance search. No Prescriptions within the listed date range : Patient was found, but no reports of prescriptions filled within dates entered. • Change the prescription fill date range. Note: Can print all patients for the day at start of day
Note Morphine Mg Equivalent /Day
How You Review Your Prescribing: My Rx Good to check monthly Your DEA # is there
List of All Your Prescriptions Written
Practical Tools to Prevent Diversion: Patient Look Up • Here is what 1 patient did in a 10 month period • Deliberate • Is this the extreme? • How many prescribers were registered for the PMP who saw this patient?
One Patient: 10 Month Period * Note all the different prescribers **Note all the new Rx’s
One Patient: 10 Month Period 32 pharmacies 49 Prescribers • 27 Dentists 84 prescriptions filled (25 private pay) • 16 MD/DO Received 500 Days of drugs in 322 • 3 Physician Days Assistants • 3 Podiatrists • 1 Nurse practitioner
Possible Scenarios from the PMP – What to do? Situation Pain agreement in Monitoring for Is Dosage Have I considered Should I refer the place? diversion? appropriate? Addiction patient Patient is going to - If not, time to do - Are there other - Ask about pain - This can be a - Evaluate the entire multiple prescribers one. Find out why indicators? control and assess symptom of picture: consider and multiple this is happening. - Should I increase functional progress addiction referral for pharmacies my monitoring, treatment for visits, urine drug addiction/pain screens, pill counts management Consistent early - If not, time to do - Other indicators of - Ask about pain - This can be a sign - Consider referral refills one. Find out why diversion? control and assess of addiction, for addiction or coming in early. - Other meds have functional progress hoarding and pain control early fills? - pseudoaddiction Pays in cash - If not, should have - Are there early - Ask about pain - Have to discern if - Need to look at the one. Good to fills? control and assess this is because no whole picture determine why this - Does patient use functional progress insurance or there is happening, is it insurance is an issue no insurance or a sometimes? different reason? Multiple addresses - If not should have - Did you check - Ask about pain - Should inquire for - Need to look at the and DOB and PMP one driver’s license control and assess other signs whole picture when patient came functional progress to your practice? - This could be typo’s or an indicator of diversion No prescriptions on - If not should have - Ask why - Is med needed at - Might be a simple - Need to evaluate PMP one - Are there other all? thing like getting the whole picture - Is this patient going signs of diversion - Ask about pain meds out of state out of state control and assess for a good reason, - Ask why functional progress then again . . . Source: James V. McDonald, MD, MPH, RI DOH
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