How does use of a prescription monitoring program change medical practice

摘要: Objectives.  The objectives of this study were to test for differences in prescription monitoring program (PMP) use between two states, Connecticut (CT) and Rhode Island (RI), with a different PMP accessibility; explore reports clinical practice; examine associations clinician's responses suspected diversion or “doctor shopping” (i.e., multiple prescriptions from providers). Design, Setting, Subjects.  From March August 2011, anonymous surveys emailed providers licensed prescribe Schedule II medications CT (N = 16,924) RI (N = 5,567). Outcome Measures.  use, patient practice, doctor shopping, diversion. Results.  Responses 1,385 prescribers received: 998 375 RI. was greater CT, where an electronic is available (43.9% vs 16.3%, χ2 = 85.2, P < 0.0001). used screen drug abuse (36.2% 10.0% RI, χ2 = 60.9, P < 0.0001) detect shopping 18.5% χ2 = 68.3, Adjusting potential confounders, by users suspicious medication behavior more likely entail response refer another provider odds ratio, OR, 1.75 [95% confidence interval, CI, 1.10, 2.80]; OR 1.93 [1.39, 2.68]; revisit pain/treatment agreement 1.97 [1.45, 2.67]; conduct urine 1.82 [1.29, 2.57]; substance treatment 1.30 [0.96, 1.75]) rather than legal intervention (OR 0.45 [0.21, 0.94]) inaction 0.09 [0.01, 0.70]). Conclusions.  Prescribers' may influence medical especially opioid detection, associated diversion.