Physician time burden associated with querying prescription drug monitoring programs

Marcus A. Bachhuber, Brendan Saloner, Marc LaRochelle, Jessica S. Merlin, Brandon C. Maughan, Dan Polsky, Naum Shaparin, Sean M. Murphy

Research output: Contribution to journalArticle

Abstract

Objective. Prescription drug monitoring programs (PDMPs) enable prescribers to review patient prescription histories, and their use is mandatory in many states. We estimated the cost of physicians retrieving PDMP patient reports compared with a model where a delegate (i.e., administrative staff) retrieves reports. Methods. We performed a cost analysis with a one-year time horizon, from the perspective of physicians’ employers. We obtained specialty-specific estimates of controlled substance prescribing frequency from the National Ambulatory Medical Care Survey, 2012–2014. We defined three PDMP usage cases based on the frequency of queries: comprehensive (before every Schedule II–IV controlled substance prescription), selective (before new Schedule II–IV prescriptions and every six months for continuing medications), and minimal (before new Schedule II or III prescriptions and annually for continuing medications). Results. The delegate model was less costly for all specialties in the comprehensive usage case and most specialties in the selective usage case, and it was similar to physician model costs in the minimal usage case. Estimated annual costs of the physician model to a large health care system (1,000 full-time equivalent physicians) were $1.6 million for comprehensive usage, $1.1 million for selective usage, and $645,313 for minimal usage. The delegate model was less costly in the comprehensive (savings of $907,283) and selective usage cases (savings of $156,216). Conclusions. Relying on delegates vs physicians to retrieve reports is less costly in most cases. Automation and integration of PDMP data into electronic health records may reduce costs further. Physicians, health care systems, and states should collaborate to streamline access to PDMPs.

Original languageEnglish (US)
Pages (from-to)1952-1960
Number of pages9
JournalPain Medicine (United States)
Volume19
Issue number10
DOIs
StatePublished - 2018

Keywords

  • Controlled substances
  • Cost analysis
  • Opioid analgesics
  • Prescription drug monitoring programs
  • Primary care

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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  • Cite this

    Bachhuber, M. A., Saloner, B., LaRochelle, M., Merlin, J. S., Maughan, B. C., Polsky, D., Shaparin, N., & Murphy, S. M. (2018). Physician time burden associated with querying prescription drug monitoring programs. Pain Medicine (United States), 19(10), 1952-1960. https://doi.org/10.1093/pm/pny053