One hundred percent of healthcare providers who are authorized to prescribe opioids and other potent medications are now enrolled in the state's prescription drug monitoring database, marking an important step in Rhode Island's work to prevent overdose deaths, the Rhode Island Department of Health (RIDOH) announced today.
Known as the Prescription Drug Monitoring Program (PDMP), this statewide database allows healthcare providers to see what controlled-substance prescriptions are being filled for their patients. In addition to preventing over-prescribing, the PDMP helps prevent drug diversion and unsafe combinations of prescribed medications. Increasing enrollment in and utilization of the database is a key target in Governor Gina M. Raimondo's overdose action plan, which aims to reduce overdose deaths by a third within three years.
"To save lives from drug overdose, we have to support safer prescribing practices," said Raimondo. "Achieving 100% enrollment in our Prescription Drug Monitoring Program is an important milestone, and we will continue to set the bar high to ensure that providers on the frontlines of Rhode Island's overdose crisis are actively using the system to keep their patients safe."
In addition to prescribers, the PDMP is used by pharmacists when filling prescriptions. Legislation from 2014 requires all prescribers of controlled substances to register for the PDMP; however, before RIDOH initiated a PDMP Education, Notification, and Enforcement Plan in January 2016, only approximately 40% of prescribers had done so. Through increased training and staff visits to practices, RIDOH helped boost enrollment to 100%.
"The Prescription Drug Monitoring Program is an indispensable tool in the fight against the epidemic of overdose in Rhode Island," said Director of Health and Overdose Task Force Co-Chair Nicole Alexander-Scott, MD, MPH. "It helps to prevent over-prescribing and promotes better coordination among healthcare providers throughout the state to ensure that patients with chronic health needs continue to get the treatment they need in a way that is as safe as possible."
In addition to ensuring all eligible users are enrolled in the PDMP, RIDOH is working to enhance the tool to make it easier for users to integrate it into their current practice and support better patient care. Rhode Island's PDMP is now connected to similar databases in Massachusetts, Connecticut, and seven other states, and prescribers will soon automatically be notified about potentially risky prescribing behaviors by any prescriber treating their patients. RIDOH is also working with practices to help connect the PDMP to patients' electronic health records.
RIDOH is now focusing efforts on increasing utilization of the PDMP to ensure compliance with 2016 legislation that requires prescribers to check the PDMP before initiating an opioid prescription and every three months while the patient is prescribed opioids. Only 24% of prescribers are currently running patient reports in the PDMP. To increase utilization, RIDOH is visiting the offices of prescribers with the highest prescribing rates to educate them on the new legislation and the value of the PDMP. RIDOH has also developed a customized prescriber profile that compares providers' prescribing patterns to state averages, demonstrates PDMP utilization rates, and indicates when patients have been to five different prescribers and/or five different pharmacists in a six-month period, an indication of possible drug diversion.
At least 171 people have died of drug overdoses in 2016. In 2015, 258 Rhode Islanders died of drug overdoses.