Date of Completion

8-24-2017

Embargo Period

8-24-2017

Advisors

Jane Ungemack, PhD; Surita Rao, MD; Bonnie McRee, PhD

Field of Study

Public Health

Degree

Master of Public Health

Open Access

Open Access

Abstract

Background: The increase in prescription opiate misuse has become one of the largest public health crises facing the United States. Prescription Drug Monitoring Programs (PDMPs) are large online databases that states use to monitor prescribing and filling of controlled drugs by physicians and pharmacies to identify patients who are misusing prescription drugs and to reduce the prevalence of opioids misuse. However, the literature is not conclusive as to whether or not PDMPs are effective in decreasing opioid misuse, and the rates of PDMP usage among physicians remains low, even in states where usage is mandatory.

Objectives: To investigate physicians' attitudes towards the use of the Connecticut Prescription Monitor and Reporting (CPMRS) and to inform a future statewide survey planned by the Connecticut Department of Consumer Protection (DCP) and to identify possible ways to increase the usage of the CPMRS and strengthen its efficacy.

Methods: A qualitative study based on semi-structured interviews with physicians was used to explore their attitudes about the use of the CPMRS and toward the opioid epidemic in general.

Findings: All participating physicians (n=10) had prescribed opioids for chronic pain and all were knowledgeable about the 2016 Centers for Disease Control (CDC) guidelines. A majority reported using the CPMRS and said that time constraints were the largest barrier to using it. Half of the physicians had used CPMRS to confirm their suspicions about specific patients’ behavior. Participants were evenly divided on whether specific “reports” comparing their opioid prescribing frequency to the prescribing frequency of other physicians in their specialty would be useful. Using the label “epidemic” to describe the current public health concerns about prescription opioids was controversial among participants, but all believed that physicians have a role in preventing prescription drug misuse and overdose.

Conclusions: Data from these interviews revealed several policy implications that may increase usage and accessibility of the CPMRS for all prescribers. These include increasing education efforts to inform prescribers about CPMRS features, incorporating the CPMRS into electronic medical records (EMRs), and offering specific training or tutorials on how to use the system effectively and time efficiently. Public health implications revealed from these interviews indicate that not all physicians are unified in their view of the current prescription opioid situation as an “epidemic” and there is concern that the medical community may “overcorrect” in their prescribing practices and block patients from receiving the medication they need to function day to day.

Major Advisor

Jane Ungemack, PhD

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