PMP
Prescription Monitoring Program is a web-based electronic database that aids in the reporting of dispensed controlled substance prescriptions.
PMP Mission
To provide practitioners, pharmacists, and other authorized users the ability to review a patient’s controlled substance prescription history and assist in the prevention of diversion, abuse, misuse, and drug overdose deaths associated with controlled substance prescriptions.
Registrants
- Healthcare Professionals
- Delegates - Up to four (4) delegates per practitioner/pharmacist, a delegate can have an unlimited number of practitioners/pharmacists
- Law Enforcement
- Regulatory Board Agents
- Medicaid Compliance Officers
Available Delegate User Roles
- Prescriber Delegate - Unlicensed
- Prescriber Delegate - Licensed
- Pharmacist Delegate - Licensed
Supervisor must have an email registered with AWARXE
All User Regulatory Facts
- Only authorized account holder can access the NM PMP.
- Sharing login information is a violation of both federal and state regulations.
- Although delegates can pull PMP patient reports on behalf of a practitioner, the practitioner is ultimately responsible to review the PMP patient report.
- The practitioner shall document the review of the PMP patient report as required per their licensing board regulation.
Medical Board Licensees Regulatory Facts
- For the initial controlled substance II-V prescription and if the day supply is greater than four (4) days, or if there is a gap in prescribing any controlled substance for 30 days or more, obtain and review the NM PMP patient report for the previous 12 months and from adjacent states if available.
- For a renewal or continuous use of a controlled substance II-V, obtain and review a NM PMP patient report no less than once every three months.
- Practitioners licensed to practice in an opioid treatment program shall review a PMP patient report upon initial enrollment into the opioid treatment program and every three (3) months thereafter while prescribing, ordering, administering, or dispensing opioid treatment medication in schedules II-V.
- Document your review!
Practitioners don’t have to check PMP when…
Practitioners do not have to consult the PMP report before prescribing, ordering, or dispensing a controlled substance II-V:
- If the dispensed quantity is for a period of 4 days or less
- To a patient in a nursing facility,
- To a patient in hospice care
- When prescribing, dispensing or administering Testosterone, Pregabalin, Lacosamide, Ezogabine, Stimulant therapy for pediatric patients less than age 14
Pharmacist Regulatory Facts
- For opioid prescriptions, obtain and review the NM PMP patient report for the previous 12 months and from adjacent states if available.
- For a renewal or continuous use of an opioid, obtain and review a NM PMP patient report (and from adjacent states if applicable) no less than once every three (3) months.
- Document your review!
Pharmacists don’t have to check PMP when…
Pharmacists do not have to consult the PMP report before dispensing a prescription for:
- an opioid written for a patient in a long term care facility (LTCF)
- for a patient with a medical diagnosis documenting a terminal illness.
Dispensers Regulatory Facts
- All dispensers (e.g. pharmacies, dispensing practitioners) must report within one business day if more than 12 doses within a 72 hour period was dispensed.
- If a dispenser did not dispense any controlled substances, a “zero report” must be submitted within one business day.
- If a dispenser becomes aware of an data entry error, the correction must be submitted to the PMP within five (5) business days.
PMPi
- The PMP InterConnect (PMPi) facilitates the transfer of PMP data across state lines.
- PMPi allows participating states across the United States to be linked, providing a more effective means of combating drug diversion and drug abuse nationwide.
- Currently, 45 states and jurisdictions have agreed to securely share PMP data through PMPi.
Information from PMP Reports
- Multiple providers and/or pharmacies
- Prescriptions obtained from nonlocal providers and/or pharmacies
- High doses of opioids
- Opioids in combination with other sedating substances (e.g. benzodiazepines)
- Early refill requests
- Cash payments when insurance is available
Opioid Overdose + Multiple Practitioners
-The risk for a patient to die from an opioid overdose increases when a patient receives prescriptions from multiple practitioners
Including: - Multiple opioids are prescribed - Care is not coordinated or communicated with other providers - Dangerous combinations of medications are prescribed
Opioid Overdose + Doses
- The risk for a patient to die from an opioid overdose increases significantly as their dose increases.
- 3x greater risk at 80-120 MME/d*
- 6x greater risk at 120-200 MME/d*
- 17x greater risk at 200+ MME/d*
Opioid Overdose + Sedatives
-The risk for a patient to die from an overdose from an opioid in combination with a sedative increases significantly with more overlap
Suspected Pharmacy/Prescriber Shopper Alerts
- Some patients will have a “Suspected Prescriber/Pharmacy Shopper Alert”
- Do not stop here!
- Continue reading and analyzing the PMP patient report.
- Provide appropriate care (e.g. contact providers and/or dispensing pharmacy, referral to SAMHSA treatment centers, contracts, etc.)
Reports Available
- Quarterly Reports to Licensing Boards
* Prescriber Feedback Report
Quarterly Reports to Licensing Boards include…
- Total number of patients
- Total number of opioid patients
- Total opioid Morphine Milligram Equivalents (MME) filled
- Total number of benzodiazepine (BZD) patients
- Total BZD Diazepam Milligram Equivalents (DME) filled
- Percent of opioid patients with ≥90 MME/day
- Percent of opioid patients with ≥90 days of opioids in 6 months
- Percent of BZD patients with prescriptions ≥30 DME/day
- Percent of BZD patients with ≥90 days of BZDs in 6 months
- Percent of opioid patients with concurrent BZDs ≥30 days
- Number of “holy trinity” patients
- Controlled substance prescriptions per prescribing day, 3 months
- Percent of estimated required reports requested
- PMP reports required under Board rules (estimated)
- PMP reports requested on patients
- Percent of patients with a total of 5 or more practitioners or pharmacies in 6 months
Prescriber Feedback Report (PFR)
- Reports reflect top 1% of prescribers with 20 or more patients receiving controlled substances within 6 month period
- Individual practitioners receive their own PFR
Break Down:
- MDs (63%)
- Nurse practitioners or other advanced practice nurses (23%)
- Osteopathic physicians or physician assistants (5%)
- Dentists (5%)
- Podiatrists, psychologists, pharmacist clinicians, or nurse midwives (all <2%)
Data Elements of PFR
- Number of opioid and benzodiazepine (BZD) patients
- PMP utilization rates for opioids and BZD
- High opioid doses
- Long term opioid patients
- High BZD doses
- Long term BZD patients
- Number of prescriptions dispensed for opioids and BZDs
- Concurrent opioid and BZD treated patients
- Multiple provider episodes
- Reference to like practitioners in New Mexico
PMP Measures
- 18% decrease in patients receiving dangerous combinations of opioids and benzodiazepine together
- 20% decrease in patients receiving controlled substances from multiple providers
- 66.1% of chronic opioid users with a PMP query
- 42.1% of chronic benzodiazepine users with a PMP query
- 20.5% of new opioid patients with a PMP query
- 22.8% of new benzodiazepine patients with a PMP query
NarxCare
The Narx Report includes a patient’s NarxScores, Predictive Risk Scores, Red Flags, Rx Graph and PDMP Data, as well as access to Resources and Care Team Communications all in a single, easy-to-use interface.
PMP Current Project
- PMP Integration within Workflow: EDIE, Electronic Health Records
- NarxCare
