Skip to main content

Table 1 Potential benefits, unintended consequences and tensions around PDMP

From: An inevitable wave of prescription drug monitoring programs in the context of prescription opioids: pros, cons and tensions

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.