Mitigating Prescription Opioid Risk: Prescription Drug Monitoring Programs

Background: Opioid-related morbidity and mortality is a serious public health issue in the United States. Prescription Drug Monitoring Program (PDMP) review prior to prescribing opioids has consistently been recommended as best practices for risk mitigation, however, access/utilization of this monitoring program remains low. Methods: This quality improvement (QI) project for improved PDMP utilization employed a pre-post survey design in a random sample of Advanced Practice Registered Nurses in Arizona. Quantitative measures included online surveys with close-ended responses to salient items from the review of literature and best practices. A follow-up survey was requested of the participants who provided their email address one month following initial survey/best practice review. Results: Forty-six APRNs responded to the preliminary survey. Of the initial respondents, 22 completed the post-intervention survey one month after the QI activity. APRNs reported improved compliance with best practice recommendations including initial PDMP review prior to prescribing opioid medication for non-cancer, non-terminal pain, reviewing morphine milligram equivalents (MMEs) of prior prescriptions, \u3c 3 month PDMP review for patients receiving chronic opioid medication, APRN addressing concerning PDMP review results, and maintaining an opioid dosage \u3c 50 MMEs. Conclusions: Targeted educational awareness for APRNs can improve utilization of PDMPs and support increased adherence to safe, opioid prescribing best practices