The difficulty of using prescription drug monitoring program among office-based physicians in the USA: a challenge to mitigate controlled substance prescriptions

Abstract

To address the usability challenge of Prescription Drug Monitoring Program (PDMP) among office-based physicians in the USA imposed by the difficulty barrier for the system usage, we sought: (1) to estimate the association between the PDMP difficulty of use and reducing or eliminating controlled substance prescriptions; and (2) to test the mediating effect of the frequency of PDMP check in the association between the PDMP difficulty of use and the reduction of controlled substance prescriptions. We conducted a cross-sectional study using nationally representative data from the 2019 National Electronic Health Records Survey with a weighted sample of 214 889 office-based physicians. Weighted bivariate chi-square tests and multivariate logistic regressions with a confidence interval of 95% were performed. Bootstrap technique was used to conduct the causal mediation analysis. A PDMP that is easier to use was significantly associated with a higher reduction or elimination of controlled substance prescriptions (OR = 1.68; 95% CI: 1.01, 2.77). Easier PDMP use was also significantly associated with more frequent PDMP check prior to prescribing a controlled substance to a patient for the first time (OR = 6.39; 95% CI: 3.36, 12.15). About third (29.79%) of the observed association between PDMP difficulty of use and reducing or eliminating controlled substance prescriptions was mediated through the frequency of PDMP check. The difficulty of PDMP limits the system’s usability which undermines the process of mitigating controlled substance prescriptions. Future efforts are needed to re-assess and regulate facilitators for difficult PDMP usage to maximise the success of this system and reach the goals behind its implementation.