Australian community pharmacists' experiences of prescription drug monitoring programs: Comparisons between mandated and non-mandated states.

Abstract

Background: Prescription drug monitoring programs (PDMPs) track patients' prescription records for high-risk medications and prompt real-time alerts to pharmacists when specific criteria are met. PDMPs are increasingly implemented by healthcare systems to attempt to mitigate harms associated with prescription opioids.

Objective: This study aims to explore and compare PDMP experiences among Australian community pharmacists from states where PDMP use is mandated and non-mandated.

Methods: A representative sample of community pharmacists from New South Wales, Queensland, Victoria and Western Australia were invited to complete an anonymous online survey. The survey collected pharmacy and pharmacist-related information and asked pharmacists to rank PDMP's usefulness and barriers on a 5-point scale. Mann-Whitney U tests were conducted to determine if there were statistically significant differences in scores between mandated and non-mandated states.

Results: In total, 690 pharmacists were included. Pharmacists in mandated states had statistically higher mean 'usefulness' scores for five out of 17 items, such as informing clinical decision-making (p<0.001) and increasing confidence to refuse medication supply (p=0.002). PDMP-related barriers were rarely reported by pharmacists, although there were statistically significant differences for specific barriers between mandated and non-mandated states. Non-mandated states had significantly higher mean scores for five barriers, including 'unsure what to do with the PDMP information' (p<0.001) and 'PDMP is not integrated into dispensing software' (p=0.005). Mandated states had statistically higher mean scores for nine barriers, including 'not all scripts appear in PDMP' (p<0.001) and 'inaccurate information in the PDMP' (p<0.001).

Conclusion: There were significant differences in pharmacists' PDMP experiences between mandated and non-mandated states, which may have policy implications given Australia's recent investment into national prescription monitoring.