Regular article
A survey of Physicians' Perspectives on the New York State Mandatory Prescription Monitoring Program (ISTOP)

https://doi.org/10.1016/j.jsat.2016.07.013Get rights and content

Highlights

  • We surveyed medical school faculty regarding their behaviors and opinions on the mandatory use of a prescription drug monitoring program.

  • A plurality of PDMP users found the system difficult to use due to routine problems with logging in and entering patient information.

  • Less than half agreed with the mandatory PDMP use policy, and less than half reported perfect compliance with the mandate.

  • PDMPs should be seamlessly integrated with electronic medical record systems to facilitate compliance with mandatory PDMP use policies.

Abstract

Background

Prescription drug monitoring programs (PDMPs) have emerged as one tool to combat prescription drug misuse and diversion. New York State mandates that prescribers use its PDMP (called ISTOP) before prescribing controlled substances. We surveyed physicians to assess their experiences with mandatory PDMP use.

Methods

Electronic survey of attending physicians, from multiple clinical specialties, at one large urban academic medical center.

Results

Of 207 responding physicians, 89.4% had heard of ISTOP, and of those, 91.1% were registered users. 45.7% of respondents used the system once per week or more. There was significant negative feedback, with 40.4% of respondents describing ISTOP as “rarely” or “never helpful,” and 39.4% describing it as “difficult” or “very difficult” to use. Physicians expressed frustration with the login process, the complexity of querying patients, and the lack of integration with electronic medical records. Only 83.1% knew that ISTOP use is mandated in almost all situations. A minority agreed with this mandate (44.2%); surgeons, males, and those who prescribe controlled substances at least once per week had significantly lower rates of agreement (22.6%, 36.2%, and 33.0%, respectively). The most common reasons for disagreement were: time burden, concerns about helpfulness, potential for under-treatment, and erosion of physician autonomy. Emergency physicians, who are largely exempt from the mandate, were the most likely to believe that ISTOP was helpful, yet the least likely to be registered users. 48.4% of non-emergency physicians reported perfect compliance with the mandate; surgeons and males reported significantly lower rates of perfect compliance (18.2% and 36.8%, respectively).

Conclusions

This study offers a unique window into how one academic medical faculty has experienced New York's mandatory PDMP. Many respondents believe that ISTOP is cumbersome and generally unhelpful. Furthermore, many disagree with, and don't comply with, its mandatory use.

Keywords

Prescription drug monitoring program
Prescription drug monitoring
Prescription monitoring program
Substance use disorder
Doctor shopping
Controlled substance monitoring

Cited by (0)

View Abstract