Prescription drug monitoring programs evaluation: A systematic review of reviews

Emma Tay; Meredith Makeham; Tracey-Lea Laba; Melissa Baysari

doi:10.1016/j.drugalcdep.2023.109887

Prescription drug monitoring programs evaluation: A systematic review of reviews

Drug Alcohol Depend. 2023 Jun 1:247:109887. doi: 10.1016/j.drugalcdep.2023.109887. Epub 2023 Apr 20.

Authors

Emma Tay¹, Meredith Makeham², Tracey-Lea Laba³, Melissa Baysari⁴

Affiliations

¹ Faculty of Medicine and Health, School of Medical Sciences, Biomedical Informatics and Digital Health, The University of Sydney, Australia; Drug Health Service, Western Sydney Local Health District, Australia. Electronic address: Emma.Tay@health.nsw.gov.au.
² Faculty of Medicine and Health, The University of Sydney, Australia; Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia.
³ Clinical and Health Sciences, University of South Australia, Australia; Centre for Health Economics Research and Evaluation, The University of Technology Sydney, Australia.
⁴ Faculty of Medicine and Health, School of Medical Sciences, Biomedical Informatics and Digital Health, The University of Sydney, Australia.

PMID: 37126936
DOI: 10.1016/j.drugalcdep.2023.109887

Abstract

Background: Prescription drug monitoring programs (PDMPs) are used to mitigate harms from high-risk medicines including misuse, prescription shopping, overdoses, and death. Previous systematic reviews report inconsistent findings. We undertook a systematic review of reviews to 1) describe and identify the methods and outcome measures used to evaluate PDMPs, 2) summarise existing evidence on outcomes and factors that influence PDMP success or benefit realisation.

Methods: MEDLINE, EMBASE, Scopus, Cochrane Database of Systematic Reviews, and PROSPERO were used to identify systematic reviews on PDMPs. Twelve papers met the inclusion criteria. Data extracted included review aim, study designs, settings, outcome measures, and key findings. Quality was assessed using AMSTAR 2 quality assessment tool.

Results: Review papers were categorised as outcome or process evaluation reviews. Process evaluation reviews described implementation processes, barriers and facilitators to PDMP use and/or implementation. Most (57%) papers described barriers which frequently included usability and data integration. Outcome evaluation papers reported impact of PDMPs on outcomes, which were opioid-focused, and findings were highly variable. Most reviews (67%) were rated as low quality, limiting the conclusions that can be drawn.

Conclusions: Inconsistent methods and outcome measures were used to evaluate PDMPs. No economic evaluations of PDMPs were found. Standardising assessment and reporting of results may improve the quality and confidence in an evidence-base to inform future roll-out and evaluation of PDMPs. Targeting barriers such as system-related challenges and negative end-user perceptions could improve sustained uptake of PDMPs, and potentially facilitate benefits realisation, including mitigating harms of high-risk prescription medicines.

Keywords: Diversion; High risk medicines; Misuse; Prescription drug monitoring program; Prescription medicines; Prescription shopping.

Publication types

Review
Systematic Review

MeSH terms

Analgesics, Opioid / therapeutic use
Drug Overdose* / drug therapy
Humans
Opioid-Related Disorders* / drug therapy
Prescription Drug Misuse* / prevention & control
Prescription Drug Monitoring Programs*
Systematic Reviews as Topic

Substances

Analgesics, Opioid