Consumer/Patient Encounters with Prescription Drug Monitoring Programs: Evidence from a Medicaid Population

Background: Prescription drug monitoring programs issue reports about a patient’scontrolled substance prescription history upon request to physicians, law enforcementofficials, and pharmacists. The dual purposes of these programs are to reduce the abuseand diversion of controlled substances while not preventing access to these medications forlegitimate medical need.Objective: The purpose of this study was to examine the experiences of Medicaid patientswith Kentucky’s Prescription Drug Monitoring Program (PDMP).Study Design: A random sample of Medicaid patients was surveyed in 2010; respondentswere matched with patient retrospective claims data from 6 months prior to the survey’sadministration.Study Setting: Kentucky Medicaid patients from across the state.Methods: A combination of patient surveys and Medicaid claims data was used to test therelationship between patient characteristics and patient-reported interactions with physiciansregarding their PDMP reports and whether they experienced difficulty obtaining or filling aprescription for a controlled substance due to a PDMP report.Results: Most Medicaid patients are unaffected by the PDMP; however, patients diagnosedwith chronic non-cancer pain conditions and patients reporting a Hispanic ethnicity aresignificantly more likely to have a physician discuss their PDMP report with them. Patientsdiagnosed with chronic non-cancer pain conditions are also significantly more likely to reportdifficulty obtaining a prescription for a controlled substance than patients that have notbeen diagnosed with chronic non-cancer pain conditions. Patients living in rural areas aresignificantly less likely than patients in urban areas to report difficulty obtaining a prescriptionfor a controlled substance.Limitations: The utilization of controlled substance prescriptions by respondents wasnot measured or monitored. The Medicaid population examined in this study may not berepresentative of the population as a whole.Conclusions: These results suggest that more attention to the consumer/patient perspectiveis warranted in maintaining a balanced approach to decreasing drug abuse and diversionwhile not limiting access to controlled substances in cases of legitimate medical needKey words: Prescription Drug Monitoring Program, Medicaid, controlled substances,chronic pain patients, patient experiences, KASPER