Katz Nathaniel, Houle Brian, Fernandez Kathrine C, Kreiner Peter, Thomas Cindy Parks, Kim MeeLee, Carrow Grant M, Audet Adele, Brushwood David
Inflexxion, Inc., Newton, Massachusetts 02464, USA.
Pain Med. 2008 Jul-Aug;9(5):587-94. doi: 10.1111/j.1526-4637.2008.00471.x. Epub 2008 Jun 28.
Prescription drug abuse and undertreatment of pain are public health priorities in the United States. Few options to manage these problems are balanced, in simultaneously supporting pain relief and deterring prescription drug abuse. Prescription monitoring programs (PMPs) potentially offer a balanced approach; however, the medical/scientific communities are not well informed about their current status and potential risks/benefits. The purpose of this study was to provide a benchmark of the current status of PMPs for healthcare providers upon which to engage PMP administrators.
A Web survey of current PMP directors with a telephone follow-up conducted in June-July 2006 regarding goals, data captured, data sharing procedures, healthcare provider training, and evaluation efforts.
Eighteen of 23 states with operating PMPs at that time participated. Eleven programs allowed physician access to PMP data. Data were delivered by mail (N = 6), fax (N = 8), e-mail (N = 1), and Websites (N = 8). Eight programs provided data to providers within 1 hour. Three states have developed provider PMP usage guidelines. Eight states developed or are developing educational programs. Two states completed or are conducting evaluations of the public health impact of PMP implementation. Five states have begun utilizing PMP data as an epidemiological tool.
Initial public safety orientation of PMPs is evolving to include improving public health and patient care. Beginning with efforts to engage healthcare providers through data sharing and education, and progressively including program evaluation on public health and patient care, our results suggest a rapid movement in the direction of utilization of PMPs to improve health care.
在美国,处方药滥用和疼痛治疗不足是公共卫生领域的重点问题。在同时支持缓解疼痛和遏制处方药滥用方面,解决这些问题的方法很少能做到平衡。处方监测项目(PMPs)可能提供了一种平衡的方法;然而,医学/科学界对其当前状况以及潜在风险/益处了解不足。本研究的目的是为医疗服务提供者提供PMPs当前状况的基准,以便与PMP管理人员进行沟通。
2006年6月至7月,对现任PMP主任进行了一项网络调查,并进行了电话随访,内容涉及目标、收集的数据、数据共享程序、医疗服务提供者培训以及评估工作。
当时有23个州运营PMPs,其中18个州参与了调查。11个项目允许医生访问PMP数据。数据通过邮件(N = 6)、传真(N = 8)、电子邮件(N = 1)和网站(N = 8)提供。8个项目在1小时内向提供者提供数据。3个州制定了提供者PMP使用指南。8个州制定或正在制定教育项目。2个州完成或正在对PMP实施的公共卫生影响进行评估。5个州已开始将PMP数据用作流行病学工具。
PMPs最初的公共安全导向正在演变,以包括改善公共卫生和患者护理。从通过数据共享和教育努力吸引医疗服务提供者开始,并逐步纳入对公共卫生和患者护理的项目评估,我们的结果表明,在利用PMPs改善医疗保健方面正迅速朝着这个方向发展。