Online database to curb prescription painkiller abuse is working, health officials say

By Kay Lazar, Globe Staff

A two-year-old online database that allows Massachusetts physicians and others who prescribe prescription painkillers to check whether their patients may be addicts who are “doctor shopping” for the powerful drugs appears to be helping stem that abuse, state health officials said Wednesday.

An analysis of a small sample of providers enrolled in the program showed a 30 percent drop in the number of their patients with questionable activity -- defined as patients who filled four or more narcotic prescriptions from at least four pharmacies within six months.

By comparison, there was only an 8 percent decrease among patients of health providers not participating in the program, said Dr. Madeleine Biondolillo, director of the state public health department’s Bureau of Health Care Safety and Quality.

Biondolillo presented the results of the analysis at a meeting of the state’s Public Health Council, an appointed panel of doctors, consumer advocates and professors.

The sample, which studied the outcomes for the state’s top 50 prescribers of narcotics, compared activity of patients between July and December of 2010, as the program was starting, with the same time period in 2011.

“Certainly we are seeing a significant improvement among those who have been enrolled in the online Prescription Monitoring Program,” Biondolillo said.

The program is aimed at curbing the soaring rates of prescription painkiller abuse. It provides health care specialists with the most recent year of data about a patient’s prescription drug use, showing the name and address of each person who prescribed a narcotic to a patient, and where the prescription was filled.

Biondolillo said the agency has started sending out unsolicited reports about patient activity to prescribers and found from surveying the specialists afterward that only 8 percent reported being “aware of all or most” of the others who were also prescribing narcotics to their patients.

And only about 9 percent said that based on their current knowledge, and information from the report, that their patient appeared to have a “legitimate medical reason” for getting the prescriptions from multiple providers.

Biondolillo said that the department last month sent letters to 100 prescribers with the highest numbers of patients who were showing questionable prescription activity, and encouraged the specialists to enroll in the online program.

Enrollment in the voluntary program has been tepid. The state’s latest count shows only about 2,800 of the tens of thousands of Massachusetts providers allowed to prescribe the medicines have signed up.

The state Senate earlier this year passed a proposal that would require providers to enroll in the program and to check the database the first time they write a patient a prescription for narcotics. That bill is pending in the House.