• Traci C Green, Marita R Mann, Sarah E Bowman, Nickolas Zaller, Xaviel Soto, John Gadea, Catherine Cordy, Patrick Kelly, and Peter D Friedmann.
• Rhode Island Hospital, 55 Claverick St., 2nd floor, Providence, RI 02903, USA. traci.c.green@gmail.com
• J Am Pharm Assoc (2003). 2013 May 1;53(3):273-81.

ObjectivesTo assess differences in prescription monitoring program (PMP) use between two states with different PMP accessibility (Connecticut [CT] and Rhode Island [RI]), to explore use of PMPs in pharmacy practice, and to examine associations between PMP use and pharmacists' responses to suspected diversion or "doctor shopping."DesignDescriptive nonexperimental study.SettingCT and RI from March through August 2011.ParticipantsLicensed pharmacists in CT and RI.InterventionAnonymous surveys e-mailed to pharmacistsMain Outcome MeasuresPMP use, use of patient reports in pharmacy practice, and responses to suspected doctor shopping or diversion.ResultsResponses from 294 pharmacists were received (CT: 198; RI: 96). PMP users were more likely to use the PMP to detect drug abuse (CT: 79%; RI: 21.9%; P < 0.01) and doctor shopping (67%; 7%; P < 0.01). When faced with suspicious medication use behavior, PMP users were less likely than nonusers to discuss their concerns with the patient (adjusted odds ratio 0.48 [95% CI 0.25-0.92]) but as likely to contact the provider (0.86 [0.21-3.47]), refer the patient back to the prescriber (1.50 [0.79-2.86]), and refuse to fill the prescription (0.63 [0.30-1.30]). PMP users were less likely to state they were out of stock of the drug (0.27 [0.12-0.60]) compared with nonusers. Pharmacists reported high interest in attending continuing education on safe dispensing (72.8%).ConclusionPharmacists are important participants in the effort to address prescription drug misuse and abuse. Current PMP use with prevailing systems had limited influence on pharmacy practice. Findings point to future research and needed practice and education innovations to improve patient safety and safer opioid dispensing for pharmacists.

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