Prescription Monitoring Programs for Regulating Opioid Prescribing: A Systematic Review

Prescription monitoring programs (PMPs) play an important role in shaping opioid prescribing practices, by monitoring those receiving and providing opioid prescriptions, and storing this information in an electronic database. Most PMPs allow providers to access patient profiles in real time, which is useful in determining whether a patient is at risk for opioid misuse. Little is known about providers' use of this tool in practice. Understanding how PMP data is used by providers, and the impact of PMPs on prescribing practices, is important to ensuring these programs are successful. We will conduct a systematic review to answer five questions across three key domains: 1.Prevalence of PMP data use: a.What proportion of healthcare providers (i.e. physicians, nurses, dentists, pharmacists, etc.) access and use PMP data in their practice? 2.Factors associated with PMP data utilization a.What provider, institutional, or regional characteristics are associated with accessing PMP data? b.What common barriers and facilitators exist to accessing PMP data in different jurisdictions? 3.PMP effectiveness in changing prescribing practices a.Do PMPs affect the quantity of opioids prescribed (or "strong opioids" prescribed) by healthcare providers? b.Do PMPs reduce inappropriate prescribing (prescribing without indication, not following prescribing guidelines) within their jurisdictions? We have engaged a team with recognized expertise in addictions and evidence synthesis, as well as the medical consultant of the Nova Scotia PMP. We will use systematic review methods, as advocated by Cochrane. We will share findings at with our knowledge users through an advisory group, Emergency Department Rounds and a Primary Care Physician Discussion Forum. The findings from this study will help inform PMP best practices, and the development and implementation of PMPs in Canadian jurisdictions where they do not currently exist.