In an opinion piece published in The New England Journal of Medicine, two emergency medicine physicians outlined their vision for an “ideal” software system to curb prescription drug abuse.
Prescription drug monitoring programs (PDMPs) have existed for two decades, but have had limited impact. Many physicians don’t want to shoulder the blame for under-treating patients with chronic pain, while pharmacists often find time-consuming data-entry systems impractical.
To address these concerns, the authors propose an ideal PDMP and suggest that its development would be a worthwhile project for IT innovators. The program would allow physicians to log in and check whether a patient’s past prescription drug use warrants new and more medication. This would allow doctors to avoid more confrontational methods of addressing whether a patient’s purported pain is legitimate, such as urine tests. The software would also allow pharmacists to log in using a code issued by the Drug Enforcement Administration, which would serve an identification number against forged or stolen prescriptions.
The authors, Jeanmarie Peronne of the University of Pennsylvania and Lewis Nelson of New York University, note that above all, “cultural change” is necessary when it comes to the “expectations of patients and providers.” They add, “Extensive education at many levels can contribute to a reduction in opioid misuse.”
“As the number of deaths associated with prescription-drug use surpasses the number of fatalities from motor vehicle crashes in many states, we can learn from the success of motor safety innovations that have mitigated mortality despite increased automobile use… to address the growing rates of illness and death associated with the pharmaceuticalization of the 21st century,” the authors conclude.