Prescription drug monitoring program utilization in Kentucky community pharmacies
Objective: Identify characteristics of Kentucky community pharmacists and community pharmacists’ practice environment associated with utilization of the Kentucky All Schedule Prescription Electronic Reporting Program (KASPER).
Methods: Surveys were mailed to all 1,018 Kentucky pharmacists with a KASPER account and an additional 1,000 licensed pharmacists without an account. Bivariate analyses examined the association between KASPER utilization and practice type (independent or chain) and practice location (rural or urban). A multivariate Poisson regression model with robust error variance estimated risk ratios (RR) of KASPER utilization by characteristics of pharmacists’ practice environment.
Results: Responses were received from 563 pharmacists (response rate 27.9%). Of these, 402 responses from community pharmacists were included in the analyses. A majority of responding pharmacists (84%) indicated they or someone in their pharmacy had requested a patient’s controlled substance history since KASPER’s inception. Bivariate results showed that pharmacists who practiced in independent pharmacies reported greater KASPER utilization (94%) than pharmacists in chain pharmacies (75%; p<0.001). Multivariate regression results found utilization of KASPER varied significantly among practice environments of community pharmacists with those who practiced in an urban location (RR: 1.11; [1.01–1.21]) or at an independent pharmacy (RR: 1.27; [1.14–1.40]) having an increased likelihood of KASPER utilization.
Conclusion: Utilization of KASPER differs by community pharmacists’ practice environment, predominantly by practice type and location. Understanding characteristics of community pharmacists and community pharmacists’ practice environment associated with PDMP use is necessary to remove barriers to access and increase utilization thereby increasing PDMP effectiveness.
2. Hernandez SH, Nelson LS. Prescription drug abuse: insight into the epidemic. Clin Pharmacol Ther. 2010;88(3):307-317. doi: 10.1038/clpt.2010.154
3. Blumenschein K, Fink J, Freeman PR, James K, Kirsh K, Steinke DT, Talbert J. Review of prescription drug monitoring programs in the United States. http://chfs.ky.gov/NR/rdonlyres/85989824-1030-4AA6-91E1-7F9E3EF68827/0/KASPEREvaluationPDMPStatusFinalReport6242010.pdf (accessed September 12, 2013).
4. National Alliance for Model State Drug Laws. Complication of state prescription monitoring program maps. http://www.namsdl.org/library/6D4C4D9F-65BE-F4BB-A428B392538E0663/ (accessed February 3, 2014).
5. Kentucky Cabinet for Health and Family Services. 2010 KASPER satisfaction survey: executive summary. http://chfs.ky.gov/NR/rdonlyres/BDC0DFC9-924B-4F11-A10A-5EB17933FDDB/0/2010KASPERSatisfactionSurveyExecutiveSummary.pdf (accessed July 12, 2013).
6. Kentucky Cabinet for Health and Family Services. 2006 KASPER satisfaction survey: executive summary. http://chfs.ky.gov/NR/rdonlyres/7607D456-68C5-4C86-BF32-BACE738B0B4B/0/2006KASPERSatisfactionSurveySummary.pdf (accessed July 12, 2013).
7. Kentucky Cabinet for Health and Family Services. 2004 KASPER satisfaction survey: executive summary. http://chfs.ky.gov/NR/rdonlyres/2DA936B2-C5E2-4A9C-B5BB-4483FF9DB9D3/0/2004KASPERSatisfactionSurveySummaryReport.pdf (accessed July 12, 2013).
8. Ulbrich TR, Dula CA, Green CG, Porter K, Bennett MS. Factors influencing community pharmacists’ enrollment in a state prescription monitoring program. J Am Pharm Assoc (2003). 2010;50(5):588-594. doi: 10.1331/JAPhA.2010.09089
9. Fass JA, Hardigan PC. Attitudes of Florida pharmacists toward implementing a state prescription drug monitoring program for controlled substances. J Manag Care Pharm. 2011;17(6):430-438.
10. Green TC, Mann MR, Bowman SE, Zaller N, Soto X, Gadea J, Cordy C, Kelly P, Friedmann PD. How does use of a Prescription Drug Monitoring Program Change Pharmacy Practice? J Am Pharm Assoc (2003). 2013;53(3):273-281. doi: 10.1331/JAPhA.2013.12094
11. Simeone R, Holland L. An evaluation of prescription drug monitoring programs. http://www.simeoneassociates.com/simeone3.pdf (accessed August 8, 2013).
12. Reisman RM, Shenoy PJ, Atherly AJ, Flowers CR. Prescription opioid usage and abuse relationships: an evaluation of state prescription drug monitoring program efficacy. Subst Abuse. 2009;3:41-51.
13. Paulozzi LJ, Kilbourne EM, Desai HA. Prescription drug monitoring programs and death rates from drug overdose. Pain Med. 2011;12(5):747-754. doi: 10.1111/j.1526-4637.2011.01062.x
14. Li G, Brady JE, Lank BH, Giglio J, Wunsch H, DiMaggio C. Prescription drug monitoring and drug overdose mortality. Inj Epidemiol. 2014;1:9.
15. Commonwealth of Kentucky, Governor Steve Beshear’s Communications Office. “One year in, landmark prescription drug bill shows huge impact.” http://migration.kentucky.gov/newsroom/governor/20130725hb1.htm (accessed March 24, 2015).
16. “Prescription drug abuse: untangling the harm.” http://www.altustimes.com/news/opinion/2400269/Prescription-drug-abuse:-Untangling-the-harm (accessed March 24, 2015).
17. Finklea, K, Sacco LN, Bagalman E. Prescription Drug Monitoring Programs. Congressional Research Service Briefing. https://fas.org/sgp/crs/misc/R42593.pdf (accessed March 24, 2015).
18. Blumenschein K, Fink J, Freeman PR, Kirsh KL, Steinke DT, Talbert J. Independent evaluation of the impact and effectiveness of the Kentucky All Schedule Prescription Electronic Reporting program (KASPER). http://www.chfs.ky.gov/NR/rdonlyres/24493B2E-B1A1-4399-89AD-1625953BAD43/0/KASPEREvaluationFinalReport10152010.pdf (accessed September 12, 2013).
19. Green TC, Zaller N, Rich J, Bowman S, Friedmann P. Revisiting Paulozzi et al.’s “Prescription Drug Monitoring Programs and Death Rates from Drug Overdose”. Pain Med. 2011;12(6):982-985. doi: 10.1111/j.1526-4637.2011.01136.x
20. U.S. Department of Agriculture Economic Research Service. Measuring rurality: rural-urban continuum codes. http://webarchives.cdlib.org/sw1wp9v27r/http:/ers.usda.gov/Briefing/Rurality/RuralUrbCon/ (accessed July 14, 2013).
21. Cicero TJ, Inciardi JA, Munoz A. Trends in abuse of Oxycontin and other opioid analgesics in the United States: 2002-2004. J Pain. 2005;6(10):662-672.
22. Cicero TJ, Surratt H, Inciardi JA, Munoz A. Relationship between therapeutic use and abuse of opioid analgesics in rural, suburban, and urban locations in the United States. Pharmacoepidemiol Drug Saf. 2007;16(8):827-840.
23. Havens JR, Talbert JC, Walker R, Leedham C, Leukefeld CG. Trends in controlled-release oxycodone (OxyContin®) prescribing among Medicaid recipients in Kentucky, 1998-2002. J Rural Health. 2006;22(3):276-278.
24. Wendel E. Pharmacists survey gives insight into the impact of the economic downturn on patients, pharmacy practice, and their communities. American Pharmacists Association. March 2009. Accessed at https://portal.pharmacist.com/AM/Template.cfm?Section=News_Releases2&template=/CM/ContentDisplay.cfm&ContentID=18987 (accessed January 23, 2014).
The authors hereby transfer, assign, or otherwise convey to Pharmacy Practice: (1) the right to grant permission to republish or reprint the stated material, in whole or in part, without a fee; (2) the right to print pr epublish copies for free distribution or sale; and (3) the right to republish the stated material in any format (electronic or printed). In addition, the undersigned affirms that the article described above has not previously been published, in whole or part, is not subject to copyright or other rights except by the author(s), and has not been submitted for publication elsewhere, except as communicated in writing to Pharmacy Practice with this document.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY-NC-ND) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.