Thomas Cindy Parks, Kim Meelee, Nikitin Ruslan V, Kreiner Peter, Clark Thomas W, Carrow Grant M
Schneider Institutes for Health Policy, Brandeis University, Waltham, MA, USA.
Pharmacoepidemiol Drug Saf. 2014 Sep;23(9):950-7. doi: 10.1002/pds.3666. Epub 2014 Jun 12.
To describe prescriber response to unsolicited patient reports from the Massachusetts prescription drug monitoring program (PDMP).
Prescribers were surveyed upon receipt of unsolicited reports of their patients' prescription history and three months later. We assessed prescribers' awareness of other prescribers listed in the report, their clinical assessment of medical necessity of all prescribed medications, actions taken by prescribers after receiving the report, and usefulness of the report.
Of the 333 respondents to the initial survey, only 28 (8.4%) were aware of most, all, or nearly all other prescribers. A total of 146 (43.8%) reported having sufficient knowledge to determine whether the prescriptions were medically necessary, of whom 102 (69.6%) felt the prescriptions were unwarranted. Of the 163 respondents to the follow-up survey, 31.3% added the report to the patient's file, 22.7% discussed the report with other prescribers on the report, 21.5% took no action, and 6% discussed the report with the patient (representing two-thirds of respondents who saw the patient after receiving the report). Most respondents felt that the report was useful for their practice and easy to understand.
Unsolicited reporting of PDMP data has the potential to improve clinical practice by alerting providers about patients with multiple prescribers and potentially medically unnecessary prescriptions.
描述开处方者对来自马萨诸塞州处方药监测项目(PDMP)的非主动提供的患者报告的反应。
在收到关于其患者处方历史的非主动报告时及三个月后对开处方者进行调查。我们评估了开处方者对报告中列出的其他开处方者的知晓情况、他们对所有已开处方药物医疗必要性的临床评估、开处方者在收到报告后采取的行动以及报告的有用性。
在初始调查的333名受访者中,只有28人(8.4%)知晓大多数、所有或几乎所有其他开处方者。共有146人(43.8%)报告有足够的知识来确定这些处方是否有医疗必要性,其中102人(69.6%)认为这些处方是不必要的。在后续调查的163名受访者中,31.3%将报告添加到患者档案中,22.7%与报告中的其他开处方者讨论了该报告,21.5%未采取行动,6%与患者讨论了该报告(占收到报告后见到患者的受访者的三分之二)。大多数受访者认为该报告对他们的工作有用且易于理解。
非主动报告PDMP数据有可能通过提醒提供者注意有多个开处方者且可能存在医疗上不必要处方的患者来改善临床实践。