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Susan

Susan Gontaszewski

Year of Award: 2016 Award State: Western Australia None > Health And Medicine
Health And Medicine > Mental Health
Health And Medicine > Rehabilitation And Pain Management
None > I.T. And Communications
Policy > Government
Social Welfare > Drugs, Alcohol And Substances
To investigate the implementation of online prescription monitoring programs - Canada, USA
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Keywords: prescription monitoring, prescribing, drugs of addiction, opioid prescribing, doctor shopping, medicines misuse.

Prescription opioid use has increased rapidly across Australia in recent years.  Diversion and misuse of these medicines represent an emergent public health issue with growing numbers of fatal overdoses attributed to prescription opioids.  

Prescription monitoring programs (PMP) are tools used by state regulatory agencies to track the prescribing and dispensing of controlled drugs in the community.  Authorised health professionals can access patient prescription histories to inform decision making on whether to issue a controlled drug prescription.  Regulators can analyse prescriber level data to identify patterns that may be non-compliant with prescribing rules or accepted standards of practice.  

Western Australia has an established PMP that is used to enforce compliance with regulatory requirements for controlled drug prescribing and provide health practitioners with patient dispensing histories.  The existing system requires upgrade to provide up-to-date data to regulators and practitioners at the point of care.  

The aim of my Churchill Fellowship was to investigate and describe the different characteristics of established monitoring programs in the United States and Canada to inform the roll out of a best practice PMP in Western Australia and provide options for governance and administration. My Fellowship involved meetings/teleconferences with 10 PMP agencies in the United States and 4 in Canada, attending the PMP National Meeting and Congressional Briefing in Washington, DC and meeting with peak bodies involved in PMP research and policy.  

Key findings and recommendations relate to three themes:

 1. Data quality and standardisation

The utility of the PMP tool is linked to the quality of the data stored in the system. In addition to the use of establish protocols for patient entity resolution, the PMP should implement strategies to support data quality throughout the prescribing and dispensing process.  Data standardisation across state PMPs supports inter-jurisdictional data sharing, national reporting and research, and streamlines development of system interfaces for cross-country roll out.   

2. External interface and engagement

PMPs cannot exist successfully in isolation.  Agencies should prioritise activities that streamline system access, integrate meaningful data into clinician workflow and support coordination of care.  Working with system users and other stakeholders is critical to improve the value and reach of PMP data.   

3. Strategies to influence prescribing

PMPs form a key pillar of clinical and regulatory strategies to influence prescribing practice.  PMPs should support compliance with prescribing rules and respond to evolving understanding of the risks associated with opioid prescribing.  PMP data should feed into systems that work with practitioners who may benefit from education and intervention to improve alignment with quality prescribing practices.

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