Advanced visualizations to interpret prescription drug monitoring program information

Prescription drug monitoring programs (PDMPs) are state-based databases that contain information about controlled substance prescriptions dispensed by pharmacies. Many states now mandate PDMP use by prescribers, despite unclear effectiveness. We hypothesize that it is possible to improve the interpretability, and hence effectiveness, of PDMPs by enhancing them.

This was a real-time simulation of an enhanced PDMP. Fifty practicing physicians (25 primary care, 25 emergency medicine) were randomized to see three cases with a standard profile or an enhanced profile that included graphical representation of prescriptions and identified risky prescribing patterns. After a two-month washout period, participants were placed in the opposite group.

Physicians presented with the enhanced profile were more likely to correctly identify patients with multiple providers (97.0% vs. 85.8%, p = 0.002), overlapping opioid and benzodiazepine prescriptions (94.7% vs. 87.5%, p = 0.03), overlapping opioid prescriptions (89.5% vs. 70.8%, p < 0.01), high daily dosages of opioids (99.2% vs. 25.0%, p = 0.02), and traveling to distant pharmacies (79.7% vs. 2.5%, p < 0.01). There was no difference in interpretation time for the three cases (standard profile 657.3 s vs. enhanced profile 686.3 s, p = 0.31).

A simulated PDMP with graphical displays and interpretation of findings was, for this cohort of emergency physicians and primary care physicians, associated with an increased ability to determine high-risk features on PDMP profiles.