Pros | Cons and tensions |
---|---|
▪ Informed and safe prescribing for patients. | ▪ Patient may not receive sufficient medications due to physicians’ fear of legal retribution (“chilling effect”). |
▪ An appropriately programed real-time PDMP is likely to reduce prescription drug diversion, doctor shopping, and related casualties. | ▪ Chilling effect may influence increased prescribing of inappropriate or inadequate alternate medications (substitution effect). |
▪ Reduction of overprescribing by the physicians. | ▪ May deter legitimate prescribing by creating confusion between the concepts of addiction and pseudo-addiction, and in treating patients with opioid dependence and pain. |
▪ Reduced risk of complications from polypharmacy. | ▪ Patients may fear of coming under scrutiny by law enforcement agencies and be deprived from medications. |
▪ Help avoiding awkward patient confrontation such as urine drug screening, and promote a more patient-centered approach to quality use of opioids. | ▪ PDMP-induced reduction of prescription opioids may increase crime particularly among illicit drug users, and push some pain patients into the illicit market. |
▪ Help monitor and detect forged prescription or stolen prescription pad/page. | ▪ Fear among the physicians of being categorised as fraudulent prescribers when they are actually prescribing in good faith but lack training. |
▪ Help reducing fraudulent prescribing and inform the professional licensing boards about inappropriate prescribing/dispensing. | ▪ Privacy concern and data security. |
▪ May reveal changes in prescribing practices and patterns, and spatial information in small geographical area may inform tailored intervention. | ▪ May negatively impact on service rapport and trust. |