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  • Prescription Drug Monitoring Programs and the Neurosurgeon: Impact on Workflow and Overall Perceptions

    Final Number:

    Maya A. Babu MD MBA; Brian V. Nahed MD, MSc; Robert F. Heary MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2018 Annual Meeting

    Introduction: Legislation creating the Prescription Drug Monitoring Program (PDMP) has been enacted in every state. Thirty-four states require mandatory verification prior to distributing outpatient controlled substances in a clinical setting. The burdens placed upon neurosurgeons, especially in the context of the postoperative patient with anticipated pain, have not been studied.

    Methods: A 30-question online survey was sent to 5,668 members of the American Association of Neurological Surgeons. Six-hundred seventeen responses were received (11% response rate). STATA SE15 was utilized to analyze the results using two-tailed t-tests.

    Results: Within the subgroup of respondents who live in one of 34 states with mandatory clinical PDMP verification, 33% stated that it takes 3 minutes or more to evaluate the average patient (p = .03); 32% believed that checking the PDMP adds time and creates disruptions in workflow (p = .04); and 35% felt that the PDMP was unhelpful in prescribing pain medications (p = .001). Of overall respondents, the PDMP helped identify patients with potential abuse issues by detecting: multiple prescriptions (60%, p=.001); inappropriate refills (29%, p=.001); and false reporting of medication history (40%; p = .001).

    Conclusions: Mandatory PDMP verification may create workflow interruptions and restrict patient access to necessary postoperative opioids. PDMP’s may assist neurosurgeons in identifying potential medication misuse. This study represents the first in which neurosurgeons were specifically surveyed and responded to the benefits and challenges of participating in a PDMP.

    Patient Care: Understanding how the PDMP, which was developed to help physicians curb opioid abuse, can be improved to reduce negative effects upon workflow will help encourage broader use as a screening and verification tool for opioid diversion.

    Learning Objectives: Understand the benefits and challenges associated with the PDMP Recognize the impact of the PDMP upon neurosurgical workflow


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